Virologic Failure and its Determinant Factors among Children in First Line on Highly Active Anti Retroviral Therapy at Felegehiwot Referral Hospital, Bahir Dar, Northwest, Ethiopia: cross-sectional study

Abstract

Introduction: Highly active antiretroviral therapy (HAART) played a critical role in the medical management of HIV infected individuals by restoring the immune function and minimizes HIV related outcomes. But treatment failure minimized these advantages and leads to an increment of morbidity and mortality with poor quality of life in all HIV patients. The aim at this study was to assess the prevalence of HIV-1 treatment failure and its determinants factors among children on first line HAART at Felegehiwot Referral Hospital. Methods: Cross sectional study was conducted on 238 children who had on first line HAART regimen using the inclusion criteria. Data were collected from patients’ chart starting from ART commencement (baseline data and other information) and interviewed using structured questionnaire. CD4 T-cells from whole blood and viral load from separated plasma were analyzed according to protocols. The collected data were analyzed using SPSS packages version 20. Descriptive statistics, odds ratio, bi-variate and multiple logistic regression analysis were used to show determinant factors association. Independent associations were considered with p<0.05. Result: Among the 238 participants enrolled, 137(57.6%) were females. The mean ages were 8.09 years and the median months on HAART from initiation were 51.93 months. A total of 25 (10.5%) participants were found to have virologic/treatment failure. The mean CD4 T-cells at base line were 342.33 cells/ml and 672.13 cells/ml respectively. Long duration on treatment, sub-optimal drug adherence, conducting faith healing, high medication dosage and ambulatory functional status at baseline were found to be significant predictors of treatment failure and showed positive odds ratio. Conclusion: This study demonstrates high virologic failure and the determinant factors of virologic failures among HAART first line children are still changing. Therefore, evidence-based intervention and early detection of treatment failure must be made to further identify the potential causes and set standardized protective mechanisms of virologic failures.