Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia

Bayou, Bekelech; Sisay, Abay; Kumie, Abera

doi:10.11604/pamj.2015.21.291.6831

Cited by 17 publications

(16 citation statements)

References 10 publications

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“…This is in agreement with the findings of a study conducted at St. Luke and Tulu Bolo Hospitals, South West Shoa Zone, Oromia [18,27]. However, it is dissimilar with the findings from a study in Tanzania [23].…”

Section: Discussionsupporting

confidence: 79%

Incidence and Predictors of Anti-Retroviral Treatment (ART) Failure among Adults Receiving HIV Care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Sisay¹,

Bekele²,

Sisay³

et al. 2017

J AIDS Clin Res

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Background: Despite availability of antiretroviral therapy, HIV is responsible for 2.7 million new infections and 2.0 million deaths from worldwide. Anti-Retroviral treatment failure is not a commonly diagnosis in healthcare facilities in Ethiopia and there is dearth of information on the extent and predictors of treatment failure among adults receiving HIV care in the study setting. The aim of the current study is to assess the incidence and predictors of Anti-Retroviral Treatment (ART) failure among adults receiving HIV care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia.Methods: Facility based retrospective cohort study design was employed on archived data from 2011 to 2016. Data compilation checklist was developed from intake card and ART follow-up card. The collected data were coded and entered using Epi Info 7 and analysed using Statistical Packages for Social Science (SPSS) version 20 software. Results:The overall incidence rate of ART treatment failure were 4.91 cases per person months follow up with 2.1, 0.24 and 0.13 immunological, clinical and virological treatment failure cases per 100 person years of follow-up respectively Conclusion:The incidence of Anti-Retroviral Treatment failure was considerable among the study participants. The predictors for ART failure were WHO stage 3 at start, CD4 count at base line, disclosure and opportunistic infections. Comprehensive interventions have to be in place to tackle treatment failure among adults on ART through rendering optimum care focusing on adults with advanced WHO stage, lower CD4 count at baseline, opportunistic infections and people who did not disclose their HIV status.

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Section: Discussionsupporting

confidence: 79%

Incidence and Predictors of Anti-Retroviral Treatment (ART) Failure among Adults Receiving HIV Care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Sisay¹,

Bekele²,

Sisay³

et al. 2017

J AIDS Clin Res

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“…This study showed, not disclosing HIV status to family or other persons was associated with an increased risk of treatment failure. The finding is in line with a study conducted at St. Luke and Tulu bolo Hospital, 14 but it contrasts with the study conducted in Addis Ababa private facilities, which showed HIV patients who did not disclose their HIV status had a lower risk of treatment failure. 12 HIV status disclosure could have positive benefits such as high social support, stronger family cohesion, and relationships, reductions in anxiety and depression, good adherence to medication and improvements in physical health which might lead to better respond to treatment.…”

Section: Discussionsupporting

confidence: 76%

“…13 But, this finding contrasts with the studies conducted in St. Luke and Tulu Bolo hospitals and Tanzania, which indicated baseline functional status did not have an association with the hazard of treatment failure. 14,25 This inconsistency could be due to differences in criteria used to measure ART failure and follow -up period across studies. Bedridden functional status ART initiation reflects the deprived health condition and immunologic deterioration of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11] In Ethiopia, the prevalence of first-line ART failure ranges from 2.4% to 17.6%. [12][13][14][15] A rampant first-line ART failure imposed a major challenge to HIV prevention and control programs. The alternate treatments after first-line ART failure are limited due to the high cost and limited options of alternative medications.…”

Section: Introductionmentioning

confidence: 99%

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<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

Asefa

Asaye

Girma

et al. 2019

HIV

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Background: Global expanded access to antiretroviral therapy has led to a rapid fall in the number of people dying from HIV-related causes. However, the remarkable achievement recorded in reducing morbidity and mortality has been affected due to the occurrence of firstline ART failure. The study was intended to identify predictors of clinical and immunologic failure of first-line ART in southwest Ethiopia. Methods: A retrospective cohort study was conducted among 737 randomly selected ART patients from 1 st January 2010 to 30 th June 2016. Trained data collectors collected the data from the patients' follow-up charts and electronic databases. The Kaplan Meier (KM) curve was used to describe the probability of survival time to antiretroviral treatment failure. Variables with a p-value of ≤ 0.05 in a multivariable cox-proportional hazard model were statistically significant predictors of first-line ART failure. Results: Among 737 HIV patients on ART followed retrospectively, 445 (60.4%) were females. During the follow-up period, the incidence rate of treatment failure was 7.3 per 100 person-year observations, and the highest rate was observed during the first 6 to 12 months of ART initiation. Not disclosing HIV status (AHR꞊ 2.04, 95% CI: 1.32-3.16), being bedridden (AHR꞊ 2.01, 95% CI: 1.02-3.98) and low hemoglobin at ART initiation (AHR꞊ 2.02, 95% CI: 1.29-3.13) were associated with an increased hazard rate for first-line ART failure. Conclusion: The study showed that predictors of first-line ART treatment failure are modifiable. Therefore, these factors should be addressed during routine care of HIV patients by health care providers to preserve the rapid exhaustion of first-line medications, improve the quality of life of the patients and reduce HIV/AIDS related deaths.

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“…In Ethiopia, first-line ART treatment failure is 19.8% (immunologic 15%, clinical 6.3%, and virologic failure 1.3%) among adult PLWHA who are on ART according to the report from private health facilities in Addis Ababa [14]; Immunologic and clinical failure was 19.7 % and 19.5 % respectively as reported from Southwest Ethiopia [15]. Documented findings from the University of Gondar referral hospital, Debremarkos, St. Luke and Tulubolo hospitals showed that immunologic failures were 22.2%, 21%, and 6.8%, respectively [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study

Asfaw

Tekelehaimanot

Shewanew

et al. 2019

Preprint

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Background: 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. Methods: 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. Results: In this study, higher odds of first-line ART failure was experinced 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). Conclusions: This study evidenced that being an urban resident, TB co-infection, poor treatment adherence, and zidovudine-based regiment were positively and independently associated with first-line ART failure. Thus, enhanced adherence counseling should be provided for those urban residents as well as substance users to improve adherence to ART; early screening and management of tuberculosis is highly recommended. Moreover, close follow up of adverse effects of ARVs must be strengthened. Keywords : determinants, first-line ART failure, HIV/AIDS, Jimma Zone, Public hospitals

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Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia

Cited by 17 publications

References 10 publications

Incidence and Predictors of Anti-Retroviral Treatment (ART) Failure among Adults Receiving HIV Care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Incidence and Predictors of Anti-Retroviral Treatment (ART) Failure among Adults Receiving HIV Care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study

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