Predictors of Time to First Line Antiretroviral Treatment Failure among Adult Patients Living with HIV in Public Health Facilities of Arba Minch Town, Southern Ethiopia.
Background
Antiretroviral therapy is a proven medication given for Human Immunodeficiency Virus positive individuals. However, first-line antiretroviral treatment failure becomes a public health issue and early detection of treatment failure is crucial for timely actions. Therefore, this study aimed to identify the predictors of time to first-line antiretroviral treatment failure among adult patients living with HIV in public health facilities of Arba Minch Town.


Methods
Institution-based retrospective cohort study was employed among 396 adult patients that were selected using simple random sampling. The data on relevant variables were extracted from patient medical cards. Bi-variable and multi-variable Cox proportional hazard regression analyses were used to identify predictors.


Results
The median survival time was 21 months. Substance use (AHR=2.94, 95% CI=1.62 to 5.32), disclosure status (AHR=1.98, 95% CI=1.03 to 3.79), time since HIV diagnosis (AHR=2.19 95% CI=1.01 to 4.79), WHO clinical stage (AHR=2.02, 95% CI=1.02 to 4.00), opportunistic infection (AHR=2.27, 95% CI=1.23 to 4.19), nutritional status (AHR=3.78, 95% CI=1.99 to 7.17), functional status (AHR=2.71 95% CI=1.33 to 5.51), CD4 count (AHR=1.99, 95% CI=1.05 to 3.75), and adherence level (AHR=1.99, 95% CI=1.05 to 3.76) were independent predictors of time to first line ART treatment failure.


Conclusion
History of substance use, lack of disclosure status, time since HIV diagnosis, advanced WHO clinical staging, low CD4 counts, opportunistic infection, functional status, poor adherence to ART and under-nutrition affect the time to first-line treatment failure among adult patients living with HIV. Therefore, preventive interventions, and information and counseling focusing on high risk groups of HIV infected adult are very important.
['Enderis|Bilcha Oumer|BO|', 'Hebo|Sultan Hussen|SH|', 'Debir|Mesfin Kote|MK|', 'Sidamo|Negussie Boti|NB|', 'Shimber|Mulugeta Shegaze|MS|']
D000293:Adolescent D000328:Adult D044966:Anti-Retroviral Agents D005002:Ethiopia D005260:Female D015658:HIV Infections D006268:Health Facilities D006801:Humans D008297:Male D008875:Middle Aged D011634:Public Health D012189:Retrospective Studies D061665:Time-to-Treatment D017211:Treatment Failure D055815:Young Adult
Arba Minch Poor adherence Under-nutrition Time to first line treatment failure