Determinants Of Virologic Failure Among Adult Clients On First Line Atiretroviral Treatment At Health Facilitiies In Woliso Town, Oromia, Central Ethiopia

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.