Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia

Ali Seid; Niguss Cherie; Kemal Ahmed

doi:10.2147/HIV.S278603

Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia

HIV AIDS (Auckl). 2020 Nov 10:12:697-706. doi: 10.2147/HIV.S278603. eCollection 2020.

Authors

Ali Seid¹, Niguss Cherie², Kemal Ahmed³

Affiliations

¹ Reproductive and Family Health Unit, Dessie Health Science College, Dessie, Ethiopia.
² Reproductive and Family Health Unit, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
³ School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Abstract

Background: Treatment failure among the population on second line antiretroviral therapy is a major public health threat. In Ethiopia there has been limited research done on second line treatment failure.

Objective: To identify determinants of virologic failure among adults on second line antiretroviral therapy in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia.

Methods: An institution-based unmatched case-control study was conducted from February 1, 2020 to April 30, 2020 on a total of 377 clients in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Clients whose viral load result >1,000 copies/mL in two consecutive results at least 3 month apart were cases, while ≤1,000 copies/mL were controls. The sample size was calculated by using Epi-Info version 7. Cases (94) and controls (283) were selected using a simple random sampling method in a ratio of cases-to-controls of 1:3. The model fitted and binary logistic assumptions were fulfilled with 95% confidence level and P-values<0.05 were taken as statistically significant.

Results: Virologic failure was predicted by poor adherence (AOR=6.060, 95% CI=2.837-12.944), not disclosing their HIV status (AOR=4.178, 95% CI=1.431-12.198), OI (AOR=4.11, 95% CI=1.827-9.246), CD4 count <100 cells/mm³ (AOR=3.497, 95% CI=1.233-9.923) and 100-350 cells/mm³ (AOR=5.442, 95% CI=2.191-13.513), low BMI <16 kg/m² (AOR=7.223, 95% CI=2.218-23.520), and young age 15-29 years (AOR=2.898, 95% CI=1.171-7.170).

Conclusion and recommendations: Determinants of second line ART virologic failure were patients who had poor adherence to ART, not disclosed, opportunistic infection, low CD4 counts <350 cell/mm³, low BMI (<16 kg/m²), and young age 15-29 year patients. Social support, disclosing their HIV status, and getting early treatment for any opportunistic infection is crucial to patients.

Keywords: HIV; Wollo; case–control study; northeast Ethiopia; second line ART; virologic failure.

Grants and funding

Wollo University funded the research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.