Determinants of Virologic failure among HIV/AIDS patients on Antiretroviral Therapy in selected Public Health facilities in Addis Ababa: A case control study

Abstract

Abstracts Background: -. World Health Organization 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. So, this study tries to identify the risk factors of virologic failure and will be an input in proper management and prevention strategy of high viral load status and subsequent treatment failure in patients on ART. Objectives: - to assess 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 conducted from 15-december/2020 to 15 february/2021 to identify determinants of virologic failure among HIVAIDS patients who are on ART in Saint Peter’s specialized hospital and Zewditu Memorial Hospital. A total of 350 participants were enrolled of which 117 cases and 233 controls in the study with 1:2ratios of cases to controls. Those who have viral suppression (VL<1000copies/ml) was taken as controls and those who doesn’t have viral load suppression were classified as cases. Data extracted from patient charts using a pre-tested structured checklist by trained health professionals. Epi info version 7.2.4 and SPSS version 25 were used for data entry and analysis respectively. Odds ratio with95% confidence interval were used to identify associated variables at P-value of ≤0.05. Bivariate and multivariable regression analysis were used to determine the independent associated factors. Results. Age 15-24 (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), 2nd line regimen (AOR =7.611), treatment failure as a reason for regimen change (AOR=16.381) were found to be the potential risk factor of viral load non -suppression among People living with HIV AIDS on antiretroviral treatment. Conclusion. Being young age group, poor adherence, long duration on treatment, 2nd line regimen were the factors which increase chance of virologic factors. HIV intervention programs need to address the specified contributing factors. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence.