Abstract:
Background: Viral load is indicated as the preferable HIV treatment monitoring method globally. The
problem of virologic failure among first line antiretroviral treatment is growing in Ethiopia despite the 3
rd
95’s target of 2025. Early identification and management of determinants of virologic failure among first line ART is the backbone for effective antiretroviral treatment. However, Ethiopia's viral suppression rate
was less than 90% by 2020 and more than 10% of adult client on ART in Woliso Town shifted to second
line ART as a result of virologic failure among first line ART failure at the end of March 2022.
Objective: To identify determinants of virologic Failure among adult clients on first line ART at Health
facilities in Woliso Town, Oromia, Central Ethiopia, 2022
Methods: Facility based unmatched case-control study was conducted at St. Luke hospital and Woliso
health center from August 1 to September 01, 2022. A total of 135 cases and 268 controls adult clients on
first-line ART were included. Participants were selected using simple random sampling technique and
data were collected by review of client’s document. Epi-info7was used for data entry and SPSS version
20 for data analysis. Variables having a P-value of less than 0.25 in bi-variable analysis were included in
multivariable logistic regression. Determinants of virologic failure were determined based on adjusted
odds ratio using 95 % CI and at a P-value of <0.05.
Result: In this study, clients with age ≥ 35 years (AOR =3.4, 95% CI: 1.6, 7.0), clients with a baseline
regimen of AZT+3TC+NVP (AOR=3.5, 95% CI: 1.4, 8.8), clients with base-line CD4 count <350 mm3
(AOR=2.3, 95% CI: 1.1, 4.5), clients who had history of appointment spacing model
(AOR=0.05,95%CI:0.03,0.10), being single marital status(AOR=3.7,95% CI:1.4,10.5),TB coinfection(AOR=2.58, 95% CI:1.3,5.1) and having opportunistic infection in last six months
(AOR=3.06,95%CI: 1.5,6.3) were factors significantly associated with virologic failure.
Conclusion and recommendation: This study showed that age ≥ 35 years, being single, baseline ART
regimen with (AZT+3TC+NVP), Baseline CD4 cell count <350 mm3
, having Tb-co infection, having
opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement to
appointment spacing model was found to be protective. It is recommended that all concerned body give
more focus to the above determinants of virologic failure in preventing virologic failure among clients on
first line anti-retroviral treatment.
