Abstract:
According to UNAIDS report of 2019, estimated 25 million people were access to antiretroviral treatment (ART). In Ethiopia more than 400,000 are taking ART. Of those patients taking ART 1.5% is on second line ART regimen. Issue of antiretroviral treatment failure becomes a major public health concern, particularly, for those on secondline. Limited studies available on magnitude and predictors of second- line treatment failure in Ethiopia.
Objective: To determine the prevalence and associated factors with second line ART regimen failure among adults living with HIV; on follow up at Adama hospital medical college in 2021 G.C.
Methods: A hospital based cross sectional study was conducted on 277 participants, by review charts, registers and interview adult patients on second line ART regimen. A pretested semi-structured questionnaire was administered by data collectors. Collected data was checked for completeness, coded and entered into Epi info Version 7 & transformed to SPSS version 25. Descriptive statistics, for characteristics of the patients. Binary logistic regression analysis was carried out for independent variables with an outcome variable to select candidate variables for multivariable analysis. Statistical association between dependent and independent variables were considered statistically significant for P-value ≤ 0.05.
Result: The prevalence of second line antiretroviral treatment failure was 5.8% (3.21-8.72). The odds of developing secondline treatment failure among those patients whose regimen were changed were about 2.6(AOR=2.56; 95%CI: 1.21-8.28) time more likely than their counter parts. Moreover the odds of developing treatment failure were more than 2 times more likely for TDF-3TC-LPV/r regimen than TDF-3TC-ATV/r,(AOR=2.41;95%CI: 1.07-6.91).Mental health problem (AOR=5.62; 95%CI: 2.52-11.86), Current CD4 count of less than 100 (AOR=3.32;95%CI: 1.63-7.91) and last BMI of less than 18.5kg/m2 ( AOR=6.81;95%CI: 3.17-14.51)
Conclusions & Recommendations: The prevalence of second-line antiretroviral treatment failure was low. Low CD4, low BMI, presence of co-morbidities and mental health problem, regimen change and LPV/r containing second-line regimen were found to be associated with second-line antiretroviral treatment failure. Therefore attention should be given for strengthening integrated chronic care service delivery practice improvement to minimize second- line treatment failure.
