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.
KEYWORDS: Time to first line treatment failure, Poor adherence,
Under-nutrition, Arba Minch

Published: 2019-05-28