Determinants of first line antiretroviral immunologic treatment failure among adult HIV Patients at Dessie Referral Hospital, may, 2015

Abstract

Introduction: Immunologic treatment failure in adult HIV patients on ART based on WHO treatments failure criteria which is recommended as anti-retroviral treatment failure diagnostic criteria especially for resource limited settings like Ethiopia where the gold standard viral load determination is not accessible. Patient, who start treatment with advanced stage in which factors lead to treatment failure is not well understood and well studied. Objective: The aim of this study was to identify determinants of first line antiretroviral treatment immunologic failure among adult HIV Patients at Dessie Referral Hospital may, 2015 Methods: A hospital based Unmatched case control study was conducted at Dessie Referral Hospital. Detailed reviews of patient record were made by using structured check list in which all required information have been collected. From adult HIV patient on antiretroviral treatment two hundred nine cases with immunological treatment failure were taken as a whole where as 209 controls have been selected in the ratio of 1:1 with computer generated simple random sampling. Data have been entered and cleaned using Epi Info version 7 then exported to SPSS version 20 for analysis. BivariableBivariable BivariableBivariable BivariableBivariableBivariable analysis has been executed then all explanatory variables with p-value of <0.2 were entered into multivariable logistic regression. Determinant factors have been identified based on p-value and AOR with 95% CI. Results: In this study base line CD4 count <50 and between 50-200 cells/micro-litter, opportunistic infections and inconsistent adherence were found to have more chance of developing immunologic failure where as being female and base line regimen ZDV+3TC+EFV were protective factors. Conclusion and recommendations: lower base line CD4 count, opportunistic infection, inconsistent adherence were found to be determinant factors to develop immunologic failure. Therefore clinicians and related health programs shall focus on the identified risk factors.