Predictors of virological treatment failure among adult HIV patients on first-line antiretroviral therapy in Woldia and Dessie hospitals, Northeast Ethiopia: a case-control study

Abstract

Background: Virological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors. However, there were few studies done on the predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Ethiopia in general, and no study was done in the study area in particular. Therefore, the aim of the study was to identify predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Woldiya and Dessie Hospitals, Northeast Ethiopia.

Method: Hospital based case-control study was conducted in Woldia and Dessie Hospitals from from 12 August 2016-28 February 2018 on 154 cases and 154 controls among adult patients on first-line antiretroviral treatment. All cases were included and comparable controls were selected using stratified random sampling technique. Data were collected by document review using checklists and entered into Epidata version 3.1 and analyzed by SPSS version 21. Multivariable logistic regression analysis was done to identify the independent predictors of virological treatment failure.

Results: In this study, statistically higher odds of virological failure was observed among patients who had current CD4 T-cell count of < 200 mm³ (AOR = 2.4, 95% CI: 1.35, 4, 18) compared withCD4 T-cell count of > 200 mm³, current body mass index(BMI) < 16 kg/m² (AOR = 4.2, 95% CI:1.85, 9.51) compared with BMI > 18.5 kg/m², BMI between 16 and 18.5 kg/m² (AOR = 3.72, 95% CI: 1.75, 7.92) versus BMI > 18.5 kg/m², poor adherence to antiretroviral therapy (AOR = 5.4, 95% CI: 2.95, 9.97) compared with good adherence.

Conclusion: This study showed that low current CD4 T-cell count and body mass index, as well as poor adherence for ART treatment predicts virological failure. Therefore, deliberate efforts are urgently needed in HIV care through improving their nutritional status by enhancing nutritional education and support, and by strengthening enhanced adherence counseling.

Keywords: Antiretroviral treatment; Case control study; Dessie Ethiopia; First-line; Virological treatment failure; Woldia.