Abstract:
Background: Anti-retroviral therapy (ART) is treatment for people infected with human immune deficiency virus by using anti-HIV drugs. ART is lifelong commitment to the clients, which needs detailed discussion about their willingness and readiness for favorable outcome. Antiretroviral treatment failure occurs when the prescribed antiretroviral drugs are unable to suppress the replication of the HIV virus, leading to persistent viral activity and progression of the disease. World Health Organization (WHO) strongly recommended initiating ART for all adults living with HIV regardless of WHO clinical stage and at any CD4 cell count. Treatment failure is progression of disease after initiation of anti-retroviral treatment: which can be seen in virological, immunologic and clinical forms either in combination or discordantly. Compared with clinical or immunological monitoring, viral load testing provides an early and more accurate indication of treatment failure. The successful management of antiretroviral treatment failure is crucial for achieving the global goal of ending the HIV/AIDS epidemic.
Objective: To determine predictors of Virological antiretroviral treatment failure among adult HIV/AIDS clients on follow-up at St. Paul and ALERT Comprehensive Hospitals, Addis Ababa, Ethiopia.
Methods: Institution based retrospective cohort study design was conducted on 426 adult clients who had started ART during study period of from December 2018 to January 2021. Data regarding socio-demographics, baseline clinical data and treatment related information were collected from patient records. Data were analyzed using SPSS version 20 after initially entered to Epi-Info version 7. Descriptive statistics, cross-tabs, and binary and multiple logistic regressions were utilized. P<0.05 was used to declare significant association.
Result: The prevalence of Virological failure was found to be 41(9.6%) among the study subjects. The highest predictor for virological failure was either not being adherent (AOR=13.40 with 95% CI (4.59-39.1) to ARVs or treatment interruption at least once AOR=5.16 with 95% CI (1.97-13.52) and p-value of 0.000.
Conclusion and recommendations: In this study the magnitude of anti-retroviral treatment failure is relatively high. Therefore, facilities providing HIV/ADS care and concerned body should pay special attention to reduce the predictors and better health outcome of their clients.