Determinants Of Antiretroviral Treatment Failure Among Human Immuno Deficiency Virus Infected Adults On First Line Anti-Retroviral Treatment At Public Hospitals Of Ambo Town, Oromia, Ethiopia

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.