HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Abstract

Introduction: Highly active antiretroviral therapy (HAART) played a critical role in the medical management of HIV infected individuals by restoring the immune function and minimizes HIV related outcomes. But treatment failure minimized these advantages and leads to an increment of morbidity and mortality with poor quality of life in all HIV patients. Objective: The aim at this study was to assess the prevalence of HIV/AIDS treatment failure and its determinants factors of patients on first line HAART at Felegehiwot Referral Hospital. Methods: Cross sectional study was conducted on 421 participants who had started first line HAART during August 2016 to September 2016. Data were collected from patients' chart starting from ART commencement and face to face interview using structured questionnaire. CD4 T-cells from whole blood and viral load from separated plasma were analyzed according to protocols. The collected data were enter in to EPI info version 3.5.1 and transfer to and analyzed using SPSS packages version 20. Descriptive statistics, odds ratio, positive and negative predictive values, life table, receiver operating characteristics curves, bi-variate and multiple logistic regression were used to analysis. Independent associations were considered with p<0.05. Result: Among the 421 participants enrolled, 292 (69.4%) were adult and 129 (30.6%) were children. More than half 243 (57.7%) of the participants were females. The adult median age at ART initiation was 38.0 years with inter quartile rage (IQR) 10 and for children 9.8 years with IQR 4. The median duration of treatment failure from initiation of treatment was 87 months (IQR 110-65 months). A total of 45 (10.7%) participants were found to have treatment failure. The median CD4 T-cells at initiation of Anti retroviral therapy were 147 cells/ micro l (IQR 226-84.5). The median time to detect virological failure was 47 months. Sensitivity of immunologic failure of predicting virological failure was 62.2%. Clinical stage II 374 (88.8%) was the predominant clinical stage. Conclusion: The prevalence of treatment failure in this study was 10.7%. Long duration on treatment, conducting faith healing, immunologic failure, high medication dosage, and ambulatory functional status at baseline and not feeling privacy during consultation and counseling were found to be significant predictors of treatment failure. Therefore early identification of associated factors and monitoring treatment failure has to be strengthened to benefit patients from prevent further complication.