Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia

Yirdaw, Kesetebirhan Delele; Hattingh, Susan

doi:10.1371/journal.pone.0125826

Cited by 43 publications

(60 citation statements)

References 31 publications

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“…This result is similar to the study reported from Southern Ethiopia. 14 This might be due to the higher rate of morbidity associated with the inability to identify failures early and switch to second-line regimen. This research identifies that patients with baseline CD4 count of <100 cells/mm 3 have higher odds of first-line ART failure, which is in line with studies conducted in Ethiopia at Debre Markos Hospital, 9 Addis Ababa public hospitals, 15 Bale Zone hospitals 11 and Gondar Teaching University Hospital.…”

Section: Discussionmentioning

confidence: 99%

Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

et al. 2020

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Background: Antiretroviral treatment failure occurred when the antiretroviral regimen is unable to control HIV infection. There is no information on antiretroviral therapy failure in this study area. Objective: The aim of this study was to assess the magnitude and associated factors of antiretroviral therapy failure among HIV-positive adult patients in Harar public hospitals from January to February 2018. Methods: An institution-based cross-sectional study was conducted using chart review data from February 2005 to July 2017. Systematic sampling technique was used to include a sample of 1094 patient charts. Data were analyzed by Statistical Package for Social Sciences version 20.0. Statistical significance was considered at p < 0.05. Results: The prevalence of first-line antiretroviral treatment failure was 21% (95% confidence interval = 18.3–23.5). Being male in sex, age of 45–54 years, patients with World Health Organization stages 3 and 4 during antiretroviral therapy initiation, a baseline CD4 count <100 cells/mm3, poor drug adherence, and on antiretroviral therapy follow-up for ⩾25 months were predictors of antiretroviral treatment failure. Conclusion: In this study, the rate of antiretroviral treatment failure is relatively high. Therefore, the concerned body should pay attention to the predictors to reduce the risk of treatment failure among this study group.

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Section: Discussionmentioning

confidence: 99%

Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

et al. 2020

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“…As a non-concurrent retrospective cohort, the study required data on exposure status at a specific earlier time-point (i.e., potential risk factors at the time of treatment onset), but also the identification of outcome events (i.e., death or censored) during the study period. Information on two important potential risk factors was not available in the healthcare records of HIV patients, i.e., JUSH: body mass index (BMI) [8,36,37,38] and viral load [39,40]. While the BMI could not be calculated due to the lack of the registered heights of patients in clinical records, measurements of viral loads were not available at the hospital during the study period.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Mortality among Adult HIV/AIDS Patients Following Antiretroviral Therapy in Southwestern Ethiopia: An Assessment through Survival Models

Seyoum

Degryse

Kifle

et al. 2017

IJERPH

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Introduction: Efforts have been made to reduce HIV/AIDS-related mortality by delivering antiretroviral therapy (ART) treatment. However, HIV patients in resource-poor settings are still dying, even if they are on ART treatment. This study aimed to explore the factors associated with HIV/AIDS-related mortality in Southwestern Ethiopia. Method: A non-concurrent retrospective cohort study which collected data from the clinical records of adult HIV/AIDS patients, who initiated ART treatment and were followed between January 2006 and December 2010, was conducted, to explore the factors associated with HIV/AIDS-related mortality at Jimma University Specialized Hospital (JUSH). Survival times (i.e., the time from the onset of ART treatment to the death or censoring) and different characteristics of patients were retrospectively examined. A best-fit model was chosen for the survival data, after the comparison between native semi-parametric Cox regression and parametric survival models (i.e., exponential, Weibull, and log-logistic). Result: A total of 456 HIV patients were included in the study, mostly females (312, 68.4%), with a median age of 30 years (inter-quartile range (IQR): 23–37 years). Estimated follow-up until December 2010 accounted for 1245 person-years at risk (PYAR) and resulted in 66 (14.5%) deaths and 390 censored individuals, representing a median survival time of 34.0 months ( IQR: 22.8–42.0 months). The overall mortality rate was 5.3/100 PYAR: 6.5/100 PYAR for males and 4.8/100 PYAR for females. The Weibull survival model was the best model for fitting the data (lowest AIC). The main factors associated with mortality were: baseline age (>35 years old, AHR = 3.8, 95% CI: 1.6–9.1), baseline weight (AHR = 0.93, 95% CI: 0.90–0.97), baseline WHO stage IV (AHR = 6.2, 95% CI: 2.2–14.2), and low adherence to ART treatment (AHR = 4.2, 95% CI: 2.5–7.1). Conclusion: An effective reduction in HIV/AIDS mortality could be achieved through timely ART treatment onset and maintaining high levels of treatment adherence.

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“…[8][9][10][11] In Ethiopia, the prevalence of first-line ART failure ranges from 2.4% to 17.6%. [12][13][14][15] A rampant first-line ART failure imposed a major challenge to HIV prevention and control programs. The alternate treatments after first-line ART failure are limited due to the high cost and limited options of alternative medications.…”

Section: Introductionmentioning

confidence: 99%

<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

Asefa

Asaye

Girma

et al. 2019

HIV

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Background: Global expanded access to antiretroviral therapy has led to a rapid fall in the number of people dying from HIV-related causes. However, the remarkable achievement recorded in reducing morbidity and mortality has been affected due to the occurrence of firstline ART failure. The study was intended to identify predictors of clinical and immunologic failure of first-line ART in southwest Ethiopia. Methods: A retrospective cohort study was conducted among 737 randomly selected ART patients from 1 st January 2010 to 30 th June 2016. Trained data collectors collected the data from the patients' follow-up charts and electronic databases. The Kaplan Meier (KM) curve was used to describe the probability of survival time to antiretroviral treatment failure. Variables with a p-value of ≤ 0.05 in a multivariable cox-proportional hazard model were statistically significant predictors of first-line ART failure. Results: Among 737 HIV patients on ART followed retrospectively, 445 (60.4%) were females. During the follow-up period, the incidence rate of treatment failure was 7.3 per 100 person-year observations, and the highest rate was observed during the first 6 to 12 months of ART initiation. Not disclosing HIV status (AHR꞊ 2.04, 95% CI: 1.32-3.16), being bedridden (AHR꞊ 2.01, 95% CI: 1.02-3.98) and low hemoglobin at ART initiation (AHR꞊ 2.02, 95% CI: 1.29-3.13) were associated with an increased hazard rate for first-line ART failure. Conclusion: The study showed that predictors of first-line ART treatment failure are modifiable. Therefore, these factors should be addressed during routine care of HIV patients by health care providers to preserve the rapid exhaustion of first-line medications, improve the quality of life of the patients and reduce HIV/AIDS related deaths.

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Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia

Cited by 43 publications

References 31 publications

Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

Risk Factors for Mortality among Adult HIV/AIDS Patients Following Antiretroviral Therapy in Southwestern Ethiopia: An Assessment through Survival Models

<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

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