Volume 7, Issue 5, September 2019, Page: 71-78
Determinants of First Line Anti-Retroviral Treatment Failure Among Adult Human Immunodeficiency Virus Infected Patients in Western Oromia Public Hospitals, West Ethiopia
Fraol Jaleta, Oromia Regional Health Bureau, Adama Public Health Research and Referral Laboratory Center, Adama, Ethiopia
Alemayehu Getahun, Department of Public Health, College of Medical and Health Science, Wollega University, Nekemte, Ethiopia
Getu Bayissa, Department of Pharmacy, College of Medical and Health Science, Wollega University, Nekemte, Ethiopia
Received: Jul. 1, 2019;       Accepted: Jul. 25, 2019;       Published: Sep. 2, 2019
DOI: 10.11648/j.ajhr.20190705.13      View  22      Downloads  20
Back ground: First line antiretroviral treatment failure has led to increased HIV associated mortality especially in resource limited setting. A determinant of First line antiretroviral treatment failure is not well studied in Ethiopia. The objective of the study was to identify determinants of first line treatment failure among adults living with HIV in western Oromia public hospitals, West Ethiopia. Method: Unmatched case control study was conducted at public hospitals of West Oromia using medical record review. Cases were adult HIV patients on ART in selected hospitals who were switched to second line ART regimen because of first line treatment failure in the past ten years (2005-2015) and Controls were adult HIV patients on ART in selected hospitals who were on first line ART for greater or equal to six month in the same years (2005-2015).Data was collected by trained nurses (counselors) using checklists developed from Ministry of Health ART follow up form and entered to EPi data version 3.1 and transferred to SPSS version 20.0 for analysis. To identify determinants of first line anti-retroviral treatment failure, multivariate analysis with P-value <0.05 was done. Results: A total of 115 cases and 345 controls were included in the study. Baseline CD4 measure (AOR [95% CI] = 3.96 [1.84, 8.54]), regimen change due to drug stock out (AOR [95% CI] = 2.54 [1.38, 4.66]), treatment interruption (AOR [95% CI] = 5.09 [2.39, 10.82]), adverse effect of drug (AOR [95% CI] = 8.49 [1.87, 38.42]) and History of opportunistic infection (AOR [95% CI] = 2.15 [1.28, 3.64] were independently associated with first line antiretroviral treatment failure. Conclusion: Intervention for First line antiretroviral treatment failure needs to emphasize on regimen change due to drug stock out, treatment interruption, history of opportunistic infection, adverse effect of drug and base line CD4 <50cell/µ.
Treatment Failure, Antiretroviral Therapy, Case Control
To cite this article
Fraol Jaleta, Alemayehu Getahun, Getu Bayissa, Determinants of First Line Anti-Retroviral Treatment Failure Among Adult Human Immunodeficiency Virus Infected Patients in Western Oromia Public Hospitals, West Ethiopia, American Journal of Health Research. Vol. 7, No. 5, 2019, pp. 71-78. doi: 10.11648/j.ajhr.20190705.13
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Heymann D. Control of Communicable Diseases Manuel. 19th ed. American Public Health Association; 19 edition (October 25, 2008); 2008. 3 p.
Aldous JL, Haubrich RH. Defining treatment failure in resource-rich settings. Curr Opin HIV AIDS [Internet]. 2009; 4 (6): 459-66. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2946177&tool=pmcentrez&rendertype=abstract
Seshaiah K V, Rao DS, Rao KS, Anuradha M, Venkatesh P, Kranthi Kumar P. Prevalence of Failure of First-Line Anti-Retroviral Therapy in HIV Patients: A Retrospective Cross-Sectional Study of Six Districts of Andhra Pradesh Over One Decade. Sch J Appl Med Sci Sch J App Med Sci [Internet]. 2015; 3 (2C): 705-9. Available from: www.saspublisher.com
Ethiopia Federal HIV/AIDS Prevention and Control Office. Guidelines for Management of Opportunistic Infections and Anti-Retroviral Treatment in Adolescents and Adults in Ethiiopia, March 2008. 2008; (March): 1-109.
Ministry of Health and Family welare of India NACO. Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents: May 2013. 2013; 40-5.
Liberia Ministry of Health and Social Welfare. Integrated Guidelines for Prevention, Testing, Care and Treatment of HIV/AIDS in Liberia 2nd Edition. 2007; (December): 1-238.
World Health Organization (WHO). Global update on the health sector response to HIV, 2014. Vol. 6. 2014.
The HJ Kaiser Family foundation. The Global HIV / AIDS Epidemic. 2017; (November): 6-9.
UNAIDS. Global Aids Response Progress Reporting 2015 [Internet]. Vol. 371, The Lancet. 2015. 218 p. Available from: www.unaids.org//unaids//2013/gr2013/UNAIDS_Global_Report_2013%5Cnhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed8&NEWS=N&AN=2008031311%5Cnhttp://www.biomedcentral.com/1471-2431/14/280
Fätkenheuer G, Theisen A, Rockstroh J, Grabow T, Wicke C, Becker K, et al. Virological treatment failure of protease inhibitor therapy in an unselected cohort of HIV-infected patients. Aids [Internet]. 1997; 11 (14): F113-6. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed4&NEWS=N&AN=1997338954
Mocroft A, Ledergerber B, Viard JP, Staszewski S, Murphy M, Chiesi A, et al. Time to virological failure of 3 classes of antiretrovirals after initiation of highly active antiretroviral therapy: results from the EuroSIDA study group. J Infect Dis [Internet]. 2004; 190 (11): 1947-56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15529259
UNAIDS. GLOBAL REPORT: UNAIDS report on the global AIDS epidemic 2013 [Internet]. Unaids. 2013. 198 p. Available from: www.unaids.org//unaids//2013/gr2013/UNAIDS_Global_Report_2013
Ethiopian Public Health Institute and FMOH. HIV Related Estimates and Projections for Ethiopia- 2014. Addis Ababa; 2014.
Wilhelmson S, Reepalu A, Balcha TT, Jarso G, Björkman P. Retention in care among HIV-positive patients initiating second-line antiretroviral therapy: A retrospective study from an Ethiopian public hospital clinic. Glob Health Action. 2016; 9 (1): 1-8.
Arg M, Tietjen I, Gatonye T, Ngwenya BN, Namushe A, Simonambanga S, et al. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Developed by the DHHS Panel on Antiretroviral Guidelines for Adults. J Ethnopharmacol [Internet]. 2016; 5 (January): 512-3. Available from: http://dx.doi.org/10.1016/S1473-3099(16)00013-X%5Cnhttp://dx.doi.org/10.1016/j.jep.2016.06.040
Nekemte refferal Hospital. Nekemte refferal Hospital Annual report. Nekemte; 2015.
Nedjo Hospital. Nedjo Hospital Annual report. Nedjo; 2015.
Gimbi Hospital. Gimbi Hospital Annual report. Gimbi; 2015.
Dembi Dollo Hospital. Dembidollo Hospital Annual report. Dembidollo; 2015.
Datay MI, Boulle A, Mant D, Yudkin P. Associations with virologic treatment failure in adults on antiretroviral therapy in South Africa. J Acquir Immune Defic Syndr. 2010 Aug; 54 (5): 489-95.
Yalemwork G, Sahilu A. Determinants of first line antiretroviral treatment failure in public hospitals of Addis Ababa, Ethiopia: unmatched case control study. J Biol Agric Healthc [Internet]. 2014; 4 (15): 1-12. Available from: http://www.iiste.org/Journals/index.php/JBAH/article/view/14197/14505
Kwobah CM, Mwangi AW, Koech JK, Simiyu GN, Siika AM. Factors Associated with First-Line Antiretroviral Therapy Failure amongst HIV-Infected African Patients: A Case-Control Study. World J AIDS. 2012; 2 (July 2011): 271-8.
Matare T, Gombe N, Shambira G, Tshimanga M, Bangure D, Mungati M, et al. Factors Associated with Human Immunodeficiency Virus First Line Treatment Failure in Zvishavane District, Zimbabwe, 2014. Austin J HIV/AIDS Res Open. 2015; 2 (1): 1-6.
Chawana TD, Reid A, Bwakura T, Gavi S, C F B Nhachi. Factors Influencing Treatment failure in HIV Positive Adult Patients on First Line Antiretroviral Therapy. Vol. 60, The Central African Journal of Medicine. 2014. p. 29-36.
Ayalew MB, Kumilachew D, Belay A, Getu S, Teju D, Endale D, et al. First-line antiretroviral treatment failure and associated factors in HIV patients at the University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia. HIV AIDS (Auckl) [Internet]. 2016; 8: 141-6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27621669%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC5015875
Sebunya R, Musiime V, Kitaka S, Ndeezi G. Incidence and risk factors for first line anti retroviral treatment failure among Ugandan children attending an urban HIV clinic. AIDS Res Ther [Internet]. 2013; 10 (1): 25. Available from: http://aidsrestherapy.biomedcentral.com/articles/10.1186/1742-6405-10-25
Haile D, Takele A, Gashaw K, Demelash H, Nigatu D. Predictors of treatment failure among adult antiretroviral treatment (ART) clients in Bale Zone Hospitals, South Eastern Ethiopia. PLoS One. 2016; 11 (10): 1-14.
Ebonyi AO, Oguche S, Ejeliogu EU, Okpe SE, Agbaji OO, Sagay SA, et al. Risk Factors for First-line Antiretroviral Treatment Failure in HIV-1 Infected Children Attending Jos University Teaching Hospital, Jos, North Central Nigeria. 2014; 4 (15): 2983-94.
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