Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia

Abstract

The use of Antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. The therapy restores immune function and reduces HIV-related adverse outcomes. However, treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. Thus,this study aimedto assess anti-retroviral treatment failure and associated factors among HIV patients on the first line ART at Mizan-Tepi University Teaching Hospital. A cross-sectional study was undertaken among adult patient who have been on ART and attending ART Clinic of Mizan-Tepi University Teaching Hospital from September 2014 to September 2018. Data were collected retrospectively by reviewing patients’ medical charts using a standard structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of anti-retroviral treatment failure, multiple stepwise backward logistic regression analysis were done. P value<.05 was considered as statistically significant. Among 221 patients included in the study, 118 (53.39%) were females. The mean weight of study participants at ART initiation was 57.04 kg. Of the 221 patients on the first line ART, 10 (4.5%) experienced treatment failure. Of these patients, 5 (50%) and 3 (30%) experienced virological failure and clinical failure, respectively. Functional status (AOR: 3, CI: [1.13–6.5], P<.001) and low baseline CD4 cell count (AOR: 4.3, CI: [3.4–10.6],P<.0001) were found to be an independent predictors of treatment failure. The rate of first-line ART treatment failure in the study setting was substantial. Functional status and low baseline CD4 cell count were found to be an independent predictors of virological, clinical and immunological failure. Therefore, more attention should be given for the lifestyle of pateints’ on ART and maximize virological tests for monitoring treatment failures. Abbreviations: AIDS = Acquired Immune Deficiency Syndrome, ART = Anti Retroviral Therapy, cART = Combination AntiRetroviral Therapy, CD4 = Clusters of Differentiation, HAART = Highly Active Anti-retroviral Therapy, HIV = Human Immunodeficiency Virus, HIVDR = HIV Drug Resistance, MDR-TB = Multi-Drug Resistance Tuberculosis, MTUTH = Mizan Tepi University Teaching Hospital, NRTI = Nucleoside Reverse-Transcriptase Inhibitors, PCP = Pneumocystis Carnivi Pneumonia, PTB = Pulmonary Tuberculosis, PUD = Peptic Ulcer Disease, UTI = Urinary Tract Infection, WHO = World Health Organization.