Revista de SIDA e investigación clínica

Determinants of Virological Failure among HIV/AIDS Patients on Antiretroviral Therapy in Selected Public Health Facilities in Addis Ababa: A Case Control Study

Abstract

Haimanot Hailu*, Wegene Ewnetu Hailu, Andalak Gizaw and Temesgen Geleta

Background: World Health Organization (WHO) recommends viral load monitoring to ensure viral load suppression is achieved and maintained, there by decreased morbidity and mortality, but large gaps remain particularly in low and middle income countries. Virologic failure and treatment failure remained a major problem in Addis Ababa. Identifying the factors for virologic failure has benefits in controlling transmission and reducing disease burden.

Objectives: To identify the determinants of virologic failure in people living with HIV on antiretroviral therapy in two selected public health facilities in Addis Ababa, Ethiopia

Methods: A hospital based case control study was to identify determinants of virologic failure among HIV/AIDS patients who are on ART in Saint Peter’s specialized hospital and Zewditu memorial hospital. A total of 350 participants were recruited with 117 cases and 233 controls with 1:2 ratios of cases to controls. Those who have viral suppression (VL<1000 copies/ml) was taken as controls and those who don’t have viral load suppression were classified as cases. Epi info version 7.2.4 and SPSS version 25 were used for data entry and analysis respectively. Bivariate and multivariable regression analysis were conducted to identify factors associated with viral load non-suppression

Results: The majority of the study participants (62.6%) were female while 38.4% were male. Factors associated with viral load non-suppression included younger age (AOR=8.883), disclosure status (AOR=9.123), poor adherence (AOR=21.953), history of chronic disease (AOR=0.14), less duration on treatment (AOR=0.193), 2^nd line regimen (AOR=7.611), and treatment failure as a reason for regimen change (AOR=16.381).

Conclusion: Being in the younger age group, poor adherence, long duration on treatment, being on second line regimen were the factors which increase chance of virologic failure. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence by focusing on age and treatment duration.