Abstract:
Background: Antiretroviral therapy has dramatically reduced Human Immunodeficiency Virus related
morbidity and mortality. Although the proportion of patient living with Human Immunodeficiency Virus
accessing antiretroviral treatment has greatly increased in recent years, the United Nations Program on
Acquired Immune Deficiency Syndrome 95-95-95 testing and treatment targets are yet to be achieved.
Objective: The main objective of this study was to identify the determinants of antiretroviral treatment failure
among adult patients on first line treatment at hospitals of Ambo town 2024.
Methods: Facility based unmatched case-control study design was done among 425 study participants from
February1-30, 2024. All cases were consecutively selected and controls were selected by simple random
sampling. Interviewer administered questionnaire and record review were used for data collection. Data were
entered in to epi- data version 4.6 then exported to SPSS to analysis data. Binary logistic regression model
was fitted to identify candidate variables of first line antiretroviral treatment failure. Variable with P value <
0.25 in bivariable binary logistic regression analysis was transferred to multivariable binary logistic regression
model to control confounder’s effects. Variables with P-value < 0.05 at 95% confidence interval for adjusted
odds ratio were statistically significant determinants of first line anti-retroviral treatment failure.
Results: A total of 139 cases and 280 controls were included in the study. With response rate of 98.6%. Age
<35years (AOR:4.21,95%CI:2.18-8.15), CD4count<200 cell/mm³ (AOR:4.12,95%CI:2.02-8.41),
BMI<18.5mg/m² (AOR:2.86,95%CI:1.41-5.77), hemoglobin<10mg/dl (AOR:2.34,95% CI:1.12-4.87), poor
adherence (AOR:2.84,95%CI:1.29-6.1), history of alcohol-use (AOR:2.57,95%CI:1.21-5.48), not disclosed
(AOR:2.56,95%CI:1.24-5.27) and ambulatory status (AOR:3.19,95% CI:1.23-8.24) were determinants of first
line ART failure.
Conclusion: Age<35years, not disclosed, ambulatory status, poor adherence, history of alcohol, CD4
count<200 cell/mm³, BMI<18.5kg/m² and hemoglobin<10mg/dl were significantly associated with first-line
antiretroviral treatment failure. Focus has to be given for patients with low base line of CD4 count and BMI
and counseling on optimal adherence are crucial to prevent first-line ART failure.
