The Influence of Age-Associated Comorbidities on Responses to Combination Antiretroviral Therapy Among People Living with HIV, at the ART Clinic of Jimma Medical Center, Ethiopia: A Hospital-Based Nested Case-Control Study

Abstract

Introduction Despite the high prevalence of age-associated comorbidities in HIV patients in sub-Saharan Africa, there is a lack of data on their influence on treatment outcomes in HIV patients. Therefore, this study aimed to assess the impact of age-associated comorbidities on responses to antiretroviral therapy (ART) among people living with HIV. Methods A hospital-based nested case–control study was conducted among adult HIV-infected patients at the Jimma Medical Center from January 3 to June 2, 2022. Data were recorded by interviewing the patients and their medical chart and analyzed using The Statistical Package for Social Science (SPSS) v. 23, and at p <0.05. The Results The overall immunological and virologic failure rates were 13.8% and 13.4%, respectively. Being male [AOR = 3.079,95% CI (1.139–8.327)], having age-associated comorbidity [AOR:10.57,95% CI (2.810–39.779)], age ≥ 50 years [AOR = 2.855, 95% CI (1.023–7.9650)], alcohol intake [AOR = 3.648,95% CI (1.118–11.897)], and having a baseline CD4+ count of < 200 cells/uL [AOR:3.862, 95% CI (1.109–13.456) were an independent predictor of immunological failure; Whereas Being alcoholic [AOR:3.11, 95% CI (1.044–9.271)], having a baseline CD4+ count of < 200 cells/uL [AOR:5.11, 95% CI (1.547–16.892)], a low medication adherence [AOR:5.92, 95% CI (1.81–19.36)], bedridden baseline functional status [AOR:3.902, 95% CI (1.237–12.307)], and lack of cotrimoxazole prophylaxis [AOR:2.735,95% CI (1.084–6.902)] were found to be an independent predictor of virologic treatment failure, but being younger (age < 50 years) was protective for virologic failure. Conclusion Out of the eight patients who were treated for HIV at least one patient had developed immunological and/or virological failure. Age-associated comorbid chronic non-communicable diseases highly influence immunological outcomes compared with virological outcomes. Health providers should pay attention to age-associated comorbidities, encourage lifestyle modifications, and counsel on medication adherence to improve clinical outcomes in patients with HIV.