Abstract:
HIV infection is a pandemic problem with 35.3 million people affected worldwide. Sub-Saharan
Africa carries the highest burden of disease with an estimated 24.7 million people infected with
the virus. In Ethiopia more than 700,000 people are infected and more than 300,000 are taking
antiretroviral (ART). Of those patients taking ART only 1.5 % are on second line ART regimen.
Treatment failure of second line ART regimen is a common problem but the overall prevalence
and risk factors are not well studied.
Objective
To assess the prevalence and factors associated with the development of second line ART
failure in adult patients taking second line ART regimen.
Method
A descriptive retrospective study was conducted by reviewing the charts of patients who were on
second line ART regimen. This study includes all patients who were currently actively taking
second line ART regimens and had regular follow up at ART clinic of JUMC until February
2019. Data on socio-demographic, clinical situation of the patient during initiation of first line
regimen, during switching to second line regimen and the current or the last clinical parameters
were included. The collected data was entered and analyzed by SPSS version 16.0 statistical
package for windows (SPSS Inc., Chicago). Chi square test was conducted to compare
proportions and a p-value < 0.05 was taken as statistically significant. Univariate and multivariate
logistic regression was used to identify factors associated with second-line treatment failure.
3
Results
There were 3046 adult HIV patients who had regular follow up at Jimma University Medical
Centre ART follow up clinic on February 2019. Of which there were 80 patients who were taking
second line ART regimens. The prevalence of second line ART failure was 5% (4/80). The
factors increased the development of second line ART treatment failure were occurrence of
opportunistic infection while on second line ART, hospitalization while on second line ART and
being for longer duration on second line ART ( P<0.05) .
Conclusion
The prevalence of second line ART failure was relatively common in this population and
measures to solve this problem should be employed by both ministry of health of Ethiopia and
healthcare professionals involved in the care of HIV/AIDS patients.
