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Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study

Received: 16 March 2019     Accepted: 14 October 2019     Published: 23 October 2019
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Abstract

Highly Active Antiretroviral Therapy (HAART) has substantially declined morbidity and mortality related to Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS). Despite this fact, first-line ART failure has emerged as a growing concern. However, factors associated with first-line ART failure are not well empathized and studied. Hence, we aimed to identify the determinants of first-line ART failure among patients attending ART in Public Hospitals Jimma, Southwest Ethiopia. A case-control study was conducted in March 2018 on a sample of 384 (288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). Cases were HIV patients aged 15 years or older who were on first-line ART regimens with documented therapeutic failure. Controls were HIV patients aged 15 years or older who were on first-line ART regimen but without evidence of therapeutic failure. Data were extracted from electronic databases and supplemented by data collected through interviewer-administered questionnaires. Bivariate and multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence intervals were used to report independently associated factors at P-value<0.05. In this study, higher odds of first-line ART failure was experienced among urban residents (AOR:2.2; 95%CI: 1.1, 3.6), smokers (AOR:5.9; 95%CI:3.2, 10.8), Khat users (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherents (AOR:2.2; 95%CI: 1.1,4.5), tuberculosis coinfection (AOR:3.9; 95%CI:2.2, 6.8), prior exposure to ART (AOR:3.8; 95%CI:1.7, 8.1), zidovudine based regimen (AOR:4.8; 95%CI: 2.5,9.0) and longer duration on ART more than 73 months (AOR:1.9; 95%CI:1.2, 3.3). This study evidenced that being an urban resident, TB co-infection, poor medication adherence, and zidovudine-based regiment were positively and independently associated with first-line ART failure. Thus, the focus should be given assessment and management of medication compliance for urban residents and longer duration ART users. Assessment and management of substance use disorders are highly recommended besides ARV medication refills. Attention should be given enhanced adherence counseling and peer support to improve adherence. Early screening and management of tuberculosis infection should be strengthened. It is advisable to initiate ART with the recommended TDF-based first-line ART regimens instead of AZT-based.

Published in Rehabilitation Science (Volume 4, Issue 2)
DOI 10.11648/j.rs.20190402.11
Page(s) 13-24
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Determinants, First-Line ART Failure, HIV/AIDS, Jimma Zone, Public Hospitals

References
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Cite This Article
  • APA Style

    Amrachu Bekele Asfaw, Aderajew Nigusie, Tamrat Shaweno, Esayas Kebede Gudina, Masrie Getnet, et al. (2019). Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study. Rehabilitation Science, 4(2), 13-24. https://doi.org/10.11648/j.rs.20190402.11

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    ACS Style

    Amrachu Bekele Asfaw; Aderajew Nigusie; Tamrat Shaweno; Esayas Kebede Gudina; Masrie Getnet, et al. Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study. Rehabil. Sci. 2019, 4(2), 13-24. doi: 10.11648/j.rs.20190402.11

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    AMA Style

    Amrachu Bekele Asfaw, Aderajew Nigusie, Tamrat Shaweno, Esayas Kebede Gudina, Masrie Getnet, et al. Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study. Rehabil Sci. 2019;4(2):13-24. doi: 10.11648/j.rs.20190402.11

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  • @article{10.11648/j.rs.20190402.11,
      author = {Amrachu Bekele Asfaw and Aderajew Nigusie and Tamrat Shaweno and Esayas Kebede Gudina and Masrie Getnet and Demuma Amdisa and Tefera Belachew Lemma and Lelisa Sena Dadi},
      title = {Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study},
      journal = {Rehabilitation Science},
      volume = {4},
      number = {2},
      pages = {13-24},
      doi = {10.11648/j.rs.20190402.11},
      url = {https://doi.org/10.11648/j.rs.20190402.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20190402.11},
      abstract = {Highly Active Antiretroviral Therapy (HAART) has substantially declined morbidity and mortality related to Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS). Despite this fact, first-line ART failure has emerged as a growing concern. However, factors associated with first-line ART failure are not well empathized and studied. Hence, we aimed to identify the determinants of first-line ART failure among patients attending ART in Public Hospitals Jimma, Southwest Ethiopia. A case-control study was conducted in March 2018 on a sample of 384 (288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). Cases were HIV patients aged 15 years or older who were on first-line ART regimens with documented therapeutic failure. Controls were HIV patients aged 15 years or older who were on first-line ART regimen but without evidence of therapeutic failure. Data were extracted from electronic databases and supplemented by data collected through interviewer-administered questionnaires. Bivariate and multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence intervals were used to report independently associated factors at P-value<0.05. In this study, higher odds of first-line ART failure was experienced among urban residents (AOR:2.2; 95%CI: 1.1, 3.6), smokers (AOR:5.9; 95%CI:3.2, 10.8), Khat users (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherents (AOR:2.2; 95%CI: 1.1,4.5), tuberculosis coinfection (AOR:3.9; 95%CI:2.2, 6.8), prior exposure to ART (AOR:3.8; 95%CI:1.7, 8.1), zidovudine based regimen (AOR:4.8; 95%CI: 2.5,9.0) and longer duration on ART more than 73 months (AOR:1.9; 95%CI:1.2, 3.3). This study evidenced that being an urban resident, TB co-infection, poor medication adherence, and zidovudine-based regiment were positively and independently associated with first-line ART failure. Thus, the focus should be given assessment and management of medication compliance for urban residents and longer duration ART users. Assessment and management of substance use disorders are highly recommended besides ARV medication refills. Attention should be given enhanced adherence counseling and peer support to improve adherence. Early screening and management of tuberculosis infection should be strengthened. It is advisable to initiate ART with the recommended TDF-based first-line ART regimens instead of AZT-based.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Determinants of First-line Antiretroviral Treatment Failure Among Patients on Antiretroviral Therapy in Public Hospitals Jimma, Southwest Ethiopia a Case-Control Study
    AU  - Amrachu Bekele Asfaw
    AU  - Aderajew Nigusie
    AU  - Tamrat Shaweno
    AU  - Esayas Kebede Gudina
    AU  - Masrie Getnet
    AU  - Demuma Amdisa
    AU  - Tefera Belachew Lemma
    AU  - Lelisa Sena Dadi
    Y1  - 2019/10/23
    PY  - 2019
    N1  - https://doi.org/10.11648/j.rs.20190402.11
    DO  - 10.11648/j.rs.20190402.11
    T2  - Rehabilitation Science
    JF  - Rehabilitation Science
    JO  - Rehabilitation Science
    SP  - 13
    EP  - 24
    PB  - Science Publishing Group
    SN  - 2637-594X
    UR  - https://doi.org/10.11648/j.rs.20190402.11
    AB  - Highly Active Antiretroviral Therapy (HAART) has substantially declined morbidity and mortality related to Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS). Despite this fact, first-line ART failure has emerged as a growing concern. However, factors associated with first-line ART failure are not well empathized and studied. Hence, we aimed to identify the determinants of first-line ART failure among patients attending ART in Public Hospitals Jimma, Southwest Ethiopia. A case-control study was conducted in March 2018 on a sample of 384 (288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). Cases were HIV patients aged 15 years or older who were on first-line ART regimens with documented therapeutic failure. Controls were HIV patients aged 15 years or older who were on first-line ART regimen but without evidence of therapeutic failure. Data were extracted from electronic databases and supplemented by data collected through interviewer-administered questionnaires. Bivariate and multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence intervals were used to report independently associated factors at P-value<0.05. In this study, higher odds of first-line ART failure was experienced among urban residents (AOR:2.2; 95%CI: 1.1, 3.6), smokers (AOR:5.9; 95%CI:3.2, 10.8), Khat users (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherents (AOR:2.2; 95%CI: 1.1,4.5), tuberculosis coinfection (AOR:3.9; 95%CI:2.2, 6.8), prior exposure to ART (AOR:3.8; 95%CI:1.7, 8.1), zidovudine based regimen (AOR:4.8; 95%CI: 2.5,9.0) and longer duration on ART more than 73 months (AOR:1.9; 95%CI:1.2, 3.3). This study evidenced that being an urban resident, TB co-infection, poor medication adherence, and zidovudine-based regiment were positively and independently associated with first-line ART failure. Thus, the focus should be given assessment and management of medication compliance for urban residents and longer duration ART users. Assessment and management of substance use disorders are highly recommended besides ARV medication refills. Attention should be given enhanced adherence counseling and peer support to improve adherence. Early screening and management of tuberculosis infection should be strengthened. It is advisable to initiate ART with the recommended TDF-based first-line ART regimens instead of AZT-based.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Public Health Department, Disease Prevention and Control Unit Mizan Teferi, Southwest, Ethiopia

  • Department of Population and Family Health, Jimma University, Jimma, Ethiopia

  • Department of Epidemiology, Jimma University, Jimma, Ethiopia

  • Departments of Internal Medicine, Jimma University, Jimma, Ethiopia

  • Department of Epidemiology, Jimma University, Jimma, Ethiopia

  • Department of Health Behaviour and Society, Jimma University, Jimma, Ethiopia

  • Department of Population and Family Health, Jimma University, Jimma, Ethiopia

  • Department of Epidemiology, Jimma University, Jimma, Ethiopia

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