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

Adane Asefa,1 Zufan Asaye,2 Abiot Girma,3 Desta Hiko3 1Department of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 2Department of Statistics, College of Natural Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3Department of Epidemiology, Faculty of Publ...

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Autores principales:	Asefa A, Asaye Z, Girma A, Hiko D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	art art failure antiretroviral therapy hiv survival analysis. Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/c258e73851a94f128564567d90886023
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spelling	oai:doaj.org-article:c258e73851a94f128564567d908860232021-12-02T12:03:41ZPredictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia1179-1373https://doaj.org/article/c258e73851a94f128564567d908860232019-12-01T00:00:00Zhttps://www.dovepress.com/predictors-of-clinical-and-immunological-failure-among-patients-on-fir-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Adane Asefa,1 Zufan Asaye,2 Abiot Girma,3 Desta Hiko3 1Department of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 2Department of Statistics, College of Natural Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, EthiopiaCorrespondence: Adane AsefaDepartment of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, EthiopiaEmail adane779@gmail.comBackground: 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 first-line 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 1st January 2010 to 30th 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.Keywords: ART, ART failure, antiretroviral therapy, HIV, survival analysisAsefa AAsaye ZGirma AHiko DDove Medical Pressarticleartart failureantiretroviral therapyhivsurvival analysis.Immunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 11, Pp 377-386 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	art art failure antiretroviral therapy hiv survival analysis. Immunologic diseases. Allergy RC581-607
spellingShingle	art art failure antiretroviral therapy hiv survival analysis. Immunologic diseases. Allergy RC581-607 Asefa A Asaye Z Girma A Hiko D Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
description	Adane Asefa,1 Zufan Asaye,2 Abiot Girma,3 Desta Hiko3 1Department of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 2Department of Statistics, College of Natural Science, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, EthiopiaCorrespondence: Adane AsefaDepartment of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, EthiopiaEmail adane779@gmail.comBackground: 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 first-line 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 1st January 2010 to 30th 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.Keywords: ART, ART failure, antiretroviral therapy, HIV, survival analysis
format	article
author	Asefa A Asaye Z Girma A Hiko D
author_facet	Asefa A Asaye Z Girma A Hiko D
author_sort	Asefa A
title	Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
title_short	Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
title_full	Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
title_fullStr	Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
title_full_unstemmed	Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia
title_sort	predictors of clinical and immunological failure among patients on first-line antiretroviral therapy (art) in southwest ethiopia
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/c258e73851a94f128564567d90886023
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Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia

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