Treatment Discontinuation in Adult HIV-Infected Patients on First-Line Antiretroviral Therapy in Nigeria

Agbaji, OO; Abah, Isaac Okoh; Falang, Kakjing D.; Ebonyi, Augustine O.; Musa, J; Ugoagwu, Placid; Agaba, Patricia A; Sagay, AS; Jolayemi, Toyin; Okonkwo, P.; Idoko, John; Kanki, Phyllis J.

doi:10.2174/1570162x1303150506181945

Cited by 11 publications

(7 citation statements)

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“…When compared to findings elsewhere in Ethiopia, discontinuation rate in the current study was higher than findings from the Tigray’s study [14] and lower than findings from the Amhara’s study [15]. In addition, this rate was lower than findings from studies conducted in Guinea-Bissau (51.1%)[39], Nigeria (28%)[40], and a multi-clinic study from Republic of Congo, Cameron and Burundi (83%)[41]. The dissimilarity in measurement[42], access to HIV care services[43], and innovation, adoption and implementation of cost-effective retention strategies could be the possible reasons of differences[44, 45].…”

Section: Discussioncontrasting

confidence: 84%

Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015

et al. 2017

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BackgroundIt is well acknowledged that antiretroviral therapy (ART) discontinuation hampers the progress towards achieving the UNAIDS treatment targets that aim to treat 90% of HIV diagnosed patients and achieve viral suppression for 90% of those on treatment. Nevertheless, the magnitude, trend and risk factors for ART discontinuation have not been explored extensively. We carried out a retrospective data analysis to assess prevalence, trend and risk factors for ART discontinuation among adults in Southwest Ethiopia.Methods12 years retrospective cohort analysis was performed with 4900 HIV-infected adult patients between 21 June 2003 and 15 March 2015 registered at the ART clinic at Jimma University Teaching Hospital. ART discontinuation could be loss to follow-up, defaulting and/or stopping medication while remaining in care. Because data for 2003 and 2015 were incomplete, the 10 years data were used to describe trends for ART discontinuation using a line graph. We used binary logistic regression to identify factors that were correlated with ART discontinuation. To handle missing data, we applied multiple imputations assuming missing at random pattern.ResultsIn total, 4900 adult patients enrolled on ART, of whom 1090 (22.3%) had discontinued, 954 (19.5%) had transferred out, 300 (6.1%) had died, 2517 (51.4%) were alive and on ART, and the remaining 39 (0.8%) had unknown outcome status. The trend of ART discontinuation showed an upward direction in the recent times and reached a peak, accounting for a magnitude of 10%, in 2004 and 2005. Being a female (AOR = 2.1, 95%CI: 1.7–2.8), having an immunological failure (AOR = 2.3, 1.9–8.2), having tuberculosis/HIV co-infection (AOR = 1.5, 1.1–2.1) and no previous history of HIV testing (AOR = 1.8, 1.4–2.9) were the risk factors for ART discontinuation.ConclusionsOne out of five adults had discontinued from ART, and the trend of ART discontinuation increased recently. Discontinued adults were more likely to be females, tuberculosis/HIV co-infected, with immunological failure and no history of HIV testing. Therefore, it is vital to implement effective programs such as community ART distribution and linkage-case-management to enhance ART linkage and retention.

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Section: Discussioncontrasting

confidence: 84%

Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015

et al. 2017

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“…The regimen change rate found in the current study is higher than findings elsewhere in Ethiopia [ 12 , 26 ]. It is also higher when compared to other cohort studies in Uganda (39.21%) [ 27 ] and Nigeria (28%) [ 28 ]. However, cohort studies from resource-rich countries like UK, Italy, and Brazil showed higher incidence rates of regimen changes (28.3–41.5 per 100 PY) [ 17 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 54%

Reasons and predictors for antiretroviral therapy change among HIV-infected adults at South West Ethiopia

et al. 2018

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ObjectiveThis retrospective cohort study is aimed to assess reasons and predictors of regimen change from initial highly active antiretroviral therapy among 1533 Human Immunodeficiency virus-infected adult patients at the Jimma University Tertiary Hospital.ResultsOne in two (47.7%) adults changed their antiretroviral therapy regimen. Patients who were above the primary level of education [Hazard ratio (HR) 1.241 (95% CI 1.070–1.440)] and with human immunodeficiency virus/tuberculosis co-infection [HR 1.405 (95% CI 1.156–1.708)] had the higher risk of regimen change than their comparator. Individuals on Efavirenz [HR 0.675 (95% CI 0.553–0.825)] and non-stavudine [HR 0.494 (95% CI 0.406–0.601)] based regimens had lower risk of regimen change.

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“…Patients with suboptimal adherence were at an increased risk of being lost to follow up when compared with those with good adherence. This was supported by studies conducted in Nigeria [16] and Vietnam [34]. The possible reason could be patients with sub-optimal adherence may have socio-demographic and clinical problems that affect their adherence initially which further affect retention in care [35].…”

Section: Discussionmentioning

confidence: 85%

“…Lost to follow up from HIV care was positively associated with young age [9, 13, 14], male sex [14, 15] single marital status [13, 16], illiteracy [13, 16], long travel time to the clinic [14, 17], bedridden functional status [18, 19], presence of opportunistic infections (OIs) and opportunistic infection prophylaxis [20, 21] low CD4 count [9, 18, 22] less advanced WHO clinical stage [21].…”

Section: Introductionmentioning

confidence: 99%

Incidence and predictors of loss to follow-up among HIV infected adults after initiation of first line anti-retroviral therapy at University of Gondar comprehensive specialized Hospital Northwest Ethiopia, 2018: retrospective follow up study

et al. 2019

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Objectives The aim of this study was to estimate the incidence of lost to follow up from anti-retroviral therapy (ART) care and identify the associated factors among human immunodeficiency virus (HIV) infected patients after first-line ART initiation at University of Gondar comprehensive specialized hospital, Northwest Ethiopia between January 2012 and January 2018. Results The overall incidence rate of lost to follow up was 12.26 per 100 person years (95% CI (10.61–14.18)). Being underweight (< 18.5 kg/m 2 ) (AHR, 1.52, 95% CI 1.01–2.28), jobless (AHR, 2.22, 95% CI 1.2–4.11), substance abuser (AHR, 1.84 95% CI 1.19–2.86), having sub-optimal adherence (fair/poor) (AHR 6.33, 95% CI (3.90–10.26)), not receiving isoniazid prophylaxis (AHR 2.47, 95% CI (1.36–4.48)), ambulatory functional status (AHR 1.94, 95% CI (1.23–3.06)), having opportunistic infections (AHR, 1.74 95% CI 1.11–2.72), having CD4 count 201–349 cells/µL (AHR 0.58, 95% CI (0.38–0.88)) were found to be significant predictors of lost to follow up from ART service.

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Treatment Discontinuation in Adult HIV-Infected Patients on First-Line Antiretroviral Therapy in Nigeria

Cited by 11 publications

References 0 publications

Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015

Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015

Reasons and predictors for antiretroviral therapy change among HIV-infected adults at South West Ethiopia

Incidence and predictors of loss to follow-up among HIV infected adults after initiation of first line anti-retroviral therapy at University of Gondar comprehensive specialized Hospital Northwest Ethiopia, 2018: retrospective follow up study

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