Magnitude and Factors Affecting Virological Treatment Failure among HIV Reactive Adults from Selected Hospitals of North Shoa Zone, Amhara Region, Ethiopia
Background: Nowadays Human Immuno-deficiency Virus (HIV) is one of the devastating and prevalent virus affecting the globe without a cure. Highly Active Antiretroviral Therapy (HAART) significantly reduced the morbidity and mortality of patients with HIV infection. Although there is increasing global use of antiretroviral therapy (ART) for the treatment of HIV/AIDs, the global trends in ART failure is growing. In developing countries including Ethiopia, particularly in our study settings,
... udy settings, information related to magnitude and correlates of virological treatment failure is scarce. Thus, this study aimed at assessing the magnitude of virological treatment failure and associated factors among HIV reactive adults at selected hospitals of north Shoa, Amhara Region, Ethiopia.Methods: a facility based cross-sectional study was conducted among 498 study participants who started their first-line HAART from August 2005 to December 2018. Data were collected from patients' charts and face-to-face interviews using a structured questionnaire. Bivariable analysis was executed to select candidate predictor variables at a p-value less than 0.2. Multivariable logistic regression (forward stepwise, conditional) analysis was used to identify factors associated with virologic failure at significant level of 5%. Model adequacy check was done by Hosmer and Lemshow (p = 0.57) and Naglkerke R Square (0.46) was calculated to express the variability of virological failure by predictors.Result: More than half 290 (58.2%) of study participants were females. The median age at ART initiation was 40 years with an interquartile range (IQR) of 15 years. The median duration of virologic failure since initiation of treatment was 96 months (IQR) of 72. The magnitude of virological treatment failure was 10.24% (95% CI: 7.57% - 12.91%). Poor ART drug adherence (AOR = 4.54; 95% CI: 2.09, 9.87), CD4 count less than 250 cell/μl (AOR = 24.88; 95% CI: 11.73, 52.81) and Poor Quality of Life (QoL) (AOR = 2.65; 95% CI: 1.12, 6.25) were independent predictors of virologic failure. Conclusion: The magnitude of Virologic ART treatment failure in this study was relatively high. Poor ART drug adherence, patients' having lower CD4 count and poorer quality of life were predictors of treatment failure. Thus, intervention program that enrich patients' health related quality of life should be implemented. Moreover, counselling that supplement the importance of drug adherence and reduction of risks that lowers CD4 counts should be given emphasis which in turn helps to prevent first-line ART treatment failure.