Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia

Mathewos Alemu Gebremichael, Mekdes Kondale Gurara, Haymanot Nigussie Weldehawaryat Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Haymanot Nigussie Weldehawaryat Tel +251921875816Email jhaymi463@yahoo.comBackground: T...

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Autores principales:	Gebremichael MA, Gurara MK, Weldehawaryat HN
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	initial antiretroviral therapy regimen change incidence survival analysis arba minch Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/f91b3cc231314271af2af4d732f60dee
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spelling	oai:doaj.org-article:f91b3cc231314271af2af4d732f60dee2021-12-02T08:40:49ZIncidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia1179-1373https://doaj.org/article/f91b3cc231314271af2af4d732f60dee2020-08-01T00:00:00Zhttps://www.dovepress.com/incidence-and-predictors-of-initial-antiretroviral-therapy-regimen-cha-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Mathewos Alemu Gebremichael, Mekdes Kondale Gurara, Haymanot Nigussie Weldehawaryat Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Haymanot Nigussie Weldehawaryat Tel +251921875816Email jhaymi463@yahoo.comBackground: The effectiveness of the initial antiretroviral therapy regimen is the key to treatment success. However, regimen change affects this treatment success. Yet, evidence on the incidence and predictors of regimen change is scarce. Therefore, the aim of this study was to assess the incidence and predictors of initial antiretroviral therapy regimen change among HIV-infected adults receiving antiretroviral therapy.Methods: An institutional-based retrospective cohort study was conducted. Data were collected from patients’ charts selected by simple random sampling. Data entered into EpiData version 4.43 and analyzed by STATA version 13. The life table was used to estimate cumulative survival. Kaplan–Meir curve and Log-rank test were used to compare the survival experience of explanatory variables. Cox proportional hazard model was used to identify predictors.Results: Five hundred and eight patients were followed for 871.87 person-years of observation with the median follow-up period of 16.12 months. The incidence rate of initial ART regimen change was 11.36 (95% CI: 9.32– 13.83) per 100 person-year and the median survival time is 54 months. Not disclosing HIV status (adjusted hazard ratio (AHR) = 5.41, 95% CI = 2.38– 12.27), co-medication with ART (AHR = 4.64, 95% CI = 1.43– 15.10), occurrence of side effect on initial regimen (AHR = 7.32, 95% CI = 4.43– 12.10), baseline CD4 count < 200 cells/mm3 (AHR = 2.18, 95% CI = 1.37– 3.47), ambulatory/bedridden baseline functional status (AHR = 3.55, 95% CI = 2.30– 5.48) were significant predictors of initial regimen change.Conclusion: The incidence rate of initial ART regimen change was found to be low. HIV disclosure status, co-medication with ART, the occurrence of side effects on an initial regimen, low baseline CD4 count, ambulatory and bedridden baseline functional status were found to be predictors.Keywords: initial antiretroviral therapy, regimen change, incidence, survival analysis, Arba MinchGebremichael MAGurara MKWeldehawaryat HNDove Medical Pressarticleinitial antiretroviral therapyregimen changeincidencesurvival analysisarba minchImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 12, Pp 315-329 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	initial antiretroviral therapy regimen change incidence survival analysis arba minch Immunologic diseases. Allergy RC581-607
spellingShingle	initial antiretroviral therapy regimen change incidence survival analysis arba minch Immunologic diseases. Allergy RC581-607 Gebremichael MA Gurara MK Weldehawaryat HN Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
description	Mathewos Alemu Gebremichael, Mekdes Kondale Gurara, Haymanot Nigussie Weldehawaryat Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Haymanot Nigussie Weldehawaryat Tel +251921875816Email jhaymi463@yahoo.comBackground: The effectiveness of the initial antiretroviral therapy regimen is the key to treatment success. However, regimen change affects this treatment success. Yet, evidence on the incidence and predictors of regimen change is scarce. Therefore, the aim of this study was to assess the incidence and predictors of initial antiretroviral therapy regimen change among HIV-infected adults receiving antiretroviral therapy.Methods: An institutional-based retrospective cohort study was conducted. Data were collected from patients’ charts selected by simple random sampling. Data entered into EpiData version 4.43 and analyzed by STATA version 13. The life table was used to estimate cumulative survival. Kaplan–Meir curve and Log-rank test were used to compare the survival experience of explanatory variables. Cox proportional hazard model was used to identify predictors.Results: Five hundred and eight patients were followed for 871.87 person-years of observation with the median follow-up period of 16.12 months. The incidence rate of initial ART regimen change was 11.36 (95% CI: 9.32– 13.83) per 100 person-year and the median survival time is 54 months. Not disclosing HIV status (adjusted hazard ratio (AHR) = 5.41, 95% CI = 2.38– 12.27), co-medication with ART (AHR = 4.64, 95% CI = 1.43– 15.10), occurrence of side effect on initial regimen (AHR = 7.32, 95% CI = 4.43– 12.10), baseline CD4 count < 200 cells/mm3 (AHR = 2.18, 95% CI = 1.37– 3.47), ambulatory/bedridden baseline functional status (AHR = 3.55, 95% CI = 2.30– 5.48) were significant predictors of initial regimen change.Conclusion: The incidence rate of initial ART regimen change was found to be low. HIV disclosure status, co-medication with ART, the occurrence of side effects on an initial regimen, low baseline CD4 count, ambulatory and bedridden baseline functional status were found to be predictors.Keywords: initial antiretroviral therapy, regimen change, incidence, survival analysis, Arba Minch
format	article
author	Gebremichael MA Gurara MK Weldehawaryat HN
author_facet	Gebremichael MA Gurara MK Weldehawaryat HN
author_sort	Gebremichael MA
title	Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
title_short	Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
title_full	Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
title_fullStr	Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
title_full_unstemmed	Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia
title_sort	incidence and predictors of initial antiretroviral therapy regimen change among hiv-infected adults receiving antiretroviral therapy at arba minch general hospital, southern ethiopia
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/f91b3cc231314271af2af4d732f60dee
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Incidence and Predictors of Initial Antiretroviral Therapy Regimen Change Among HIV-Infected Adults Receiving Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia

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