Prevalence and associated factors for development of Second-line antiretroviral treatment failure among Adult patients with hiv/aids on follow up at art clinic Of jimma university medical center, jimma, south west Of Ethiopia

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.