Journal of AIDS & Clinical Research

Treatment Failure and Associated Factors at Second Line Regimen among HIV Infected Patients in Government Hospitals in Amhara Region, Ethiopia

Abstract

Awoke Seyoum Tegegne* and Getu Degu Alene

Background: Treatment failure a current issue that is related to patients to transfer from one regimen to a more advanced and a costly treatment result to the progress of HIV/AIDS control. Many HIV patients in the world transferred from first-regimen to the second-regimen because of treatment failure. This leads the program to be more resource intensive and needs to identify predictors for treatment failure at second line regimen. Therefore, the purpose of this study was to investigate the prevalence of treatment failure and the associated factors among HIV/AIDS under second line ART regimen in Amhara region, Ethiopia.

Materials and methods: An institutional based repeated follow ups of 700 HIV positive individuals, who were switched to second line regimen from January 2020 to December 2022 in 17 government hospitals in Amhara region was conducted. Inferential statistics including the Chisquare test and multivariable logistic regression analysis was applied to investigate factors associated with treatment failure. Associations between treatment failure and the predictors was based on a P-value of less than 5% and confidence intervals level of 95%.

Results: Among the covariates, age of the patients (AOR=1.122, 95% CI: 1.013, 2.234), baseline CD4 cell count (AOR=0.888, 95% CI: 0.714, 0.945), patients living without their partner (AOR=1.212, 95% CI: 1.051, 1.123), females under treatment (AOR=0.786, 95% CI; 0.564, 0.845), non-opportunistic diseases (AOR=0.865, 95% CI: 0.731, 0.938), patients not disclosed their HIV status (AOR=1.241, 95% CI: 1.087, 2.341), rural patients (AOR=1.135, 95% CI: 1.032, 1.453, patient with no education (AOR=1.125, 95% CI: 1.056, 1.546), patients with low adherence (AOR=1.225, 95% CI: 1.191, 2.453), bedridden patients (AOR=1.223, 95% CI: 1.131, 1.521), ambulatory patients (AOR=1.156, 95% CI:1.091, 1.267), non-smoker patients (AOR=0.854, 95% CI: 0.686, 0.935) significantly affected on the variable of interest. Similarly, alcohol intake, drug toxicity and baseline clinical WHO stages significantly affected for the development of tuberculosis in HIV-positive patients under treatment.

Conclusion: In this study, baseline CD4 cell count, female patients, non-opportunistic diseases, and non-smoking status were negatively associated with the development of TB, whereas, age of patients, living without partners, patients with no education, patients with low adherence, bedridden and ambulatory patients were positively associated to the development of TB in HIV patients. The findings obtained in this study are important for both service providers to conduct health-related education and patients to take care of their medication adherence. More attention should be given to those positively associated variables to response variables. The regional health bureau should open TB/HIV co-infection subsections like ART sections in each hospital.

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