Virological and Immunological Antiretroviral Treatment Failure and Predictors Among HIV Positive Adult and Adolescent Clients in Southeast Ethiopia

Abstract

Background Antiretroviral therapy (ART) regimen failure is linked to an increased risk of disease progression and death, while early detection of ART failure can help to prevent the development of resistance. This study aimed to evaluate virological and immunological ART failure and predictors among HIV-positive adult and adolescent clients in southeast Ethiopia. Methods A retrospective cohort study was implemented from January 2016 to November 30, 2020; all HIV-positive nave patients on follow-up during the study period from four hospitals were included. Virological and immunological treatment failure was the primary outcome of the study. Cox proportional hazards regression models were employed for analysis. Hazard ratios with 95% confidence intervals were reported and variables with p-values <0.05 were considered statistically significant predictors of treatment failure. Results A total of 641 HIV patients’ charts were reviewed, 62.6% of the study participants were females. Of the total study participants, 18.4% and 15% developed virological and immunological ART regimen treatment failure respectively. The median time to virological failure was 40 months. WHO stage IV [AHR = 4.616; 95% CI: (2.136–9.974)], WHO stage III [AHR = 2.323; 95% CI: (1.317–4.098)], poor adherence to HAART regimen [AHR = 3.097; 95% CI: (1.349–7.108)], and fair adherence [AHR = 2.058; 95% CI: (1.234–3.432)] were significantly associated with virological treatment failure among adolescent and adult study participants in southeast Ethiopia. Conclusion The prevalence of virological treatment failure was 18.4% (95% CI: 15.4 −21.4) and the prevalence of immunological treatment failure was 15% (95% CI: 11.8–18.4). WHO clinical stage III/IV and non-adherence were independent predictors of virological ART treatment failure. Early management of clinical WHO stages and improving patients’ ART regimen adherence are important to decrease the prevalence of ART regimen treatment failure.

Determinants of Virological Failure in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Cross-Sectional Study in the Upper East Region of Ghana

“…Findings in this study identified the number of doses missed as a key predictor of virological failure in patients who missed two or more doses within a month. This result is in accordance with the literature in North Eastern Ethiopia [12] and South Eastern Ethiopia [36], where patients who missed their appointments were likely to miss their doses and increase the odds of virological failure. Other studies from Myanmar [37] and Australia [38] also agreed with this finding, that missed appointments caused missed doses among patients on ART.…”

Assessment of Treatment Outcomes of HIV Patients at the Omdurman management AIDS counseling Unit (OMACU) through using the Viral Load from March 2020 –August 2022

“…These variations in the virologic failure rates might be attributed to the differences in geographical areas, follow-up durations, and the types of ART regimens used.Considerably, this study reported that patients with WHO stages IV during the initiation of ART were more likely to develop virologic failure than others (OR = 12.5; CI = 2.3-67.1; P = 0.003). Consistently, Desalegn G et al (8), Mamo A et al(42) and Fiona M et al(45) stated that advanced WHO clinical stages were signi cant risk factors for virological treatment failure. The present study showed that those with poor adherence levels were three times more likely to develop virological treatment failure when compared to those with good adherence levels (OR = 23.1; CI: 3.9-136.1; P = 0.001).…”

“…However, only 22% of the estimated PLHIV will be under treatment by the end of 2019. Planned efforts were severely affected by the political instability in the country during 2019 (40)(41)(42)(43). Moreover, regular treatment failure detection is low because of inadequate capacity and a lack of laboratory facilities in resource-limited settings, including Sudan.…”

Factors Influencing Survival Status of HIV/AIDS after HAART in Huzhou City, Eastern China

“…The results of this study showed that the risk of AIDS-related death in patients with clinical stage III/IV disease was higher than that in patients with stage I/II disease. HIV-infected patients with asymptomatic signs at baseline have a lower risk of death after antiretroviral therapy, suggesting that early HAART is beneficial to maintaining and rebuilding immune function, delaying disease progression, and reducing mortality [ 21 ].…”