Antiretroviral treatment failure among HIV-positive adults taking first-line therapy and associated risk factors at Adigrat General hospital, Adigart, Ethiopia 2019: A cross sectional study
Antiretroviral treatment failure among HIV-positive adults taking first-line therapy and associated risk factors at Adigrat General hospital, Adigart, Ethiopia 2019: A cross sectional study
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DOI：
10.1016/j.ijso.2020.08.001
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发表时间：
2020-01-01
影响因子：
1
通讯作者：
Gebrie, Desye
中科院分区：
文献类型：
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作者：
Getnet Demsie, Desalegn;Tilahun Bantie, Abere;Gebrie, Desye
背景：人类免疫缺陷病毒（HIV）是全球性的重大公共卫生问题。高效抗逆转录病毒疗法（HAART）大大降低了死亡率。然而，有效的治疗受到治疗失败的挑战。抗逆转录病毒治疗（ART）失败可能使患者易患新的或复发的临床conditions.Objective：本研究旨在评估病毒学和免疫学失败的高度活跃的抗逆转录病毒治疗用户和相关的危险因素在阿迪格拉特综合医院，阿迪格拉特，Ethiopia.Methods：机构为基础的回顾性横断面研究进行。数据通过预测试的结构化检查表收集。将数据输入Epi-info第7版，并导出至SPSS第22.0版进行分析。采用多变量二元Logistic回归分析变量之间的相关性。结果：784例患者纳入本研究。在所有研究参与者中，508人（64.8%）为女性。超过一半的参与者376（47.96%）的年龄范围在（31-45）岁。治疗失败的总患病率为27.48%;其中12.35%的参与者发生免疫学失败，4.70%的参与者同时发生免疫学和病毒学失败。多变量分析后与治疗失败显著相关的因素为农村居民[AOR = 3.6; 95%CI（1.11-7.36）]，WHO III/IV期[AOR = 2.7; 95% CI（1.21-5.08）]，基线CD 4计数（细胞/mm（3））小于199 [AOR = 8.11; 95% CI（2.46-19.54）]，治疗中断[AOR = 5.4; 95% CI（2.61-10.45）]、服药依从性差[AOR = 5.9; 95% CI（1.15-12.43）]、结核/HIV合并感染[AOR = 4.6; 95% CI（1.33-12.12）]。多因素分析显示，农村居民、WHO临床分期III/IV、基线CD 4计数（细胞/mm 3）小于200、治疗中断、药物依从性差、机会性感染和TB/HIV合并感染与治疗失败显著相关。(c)2020年，任作家。由Elsevier Ltd代表Surgical Associates Ltd发布。
Background: Human Immunodeficiency Virus (HIV) is a major public health problem globally. Highly active antiretroviral therapy (HAART) has led to profound reduction in the incidence of mortality. However, effective treatment is challenged by the treatment failure. Anti-Retroviral Treatment (ART) Failure may predispose patients to new or recurrent clinical condition.Objective: This study was designed to assess virological and immunological failure of highly active antiretroviral therapy users and associated risk factors at Adigrat General Hospital, Adigrat, Ethiopia.Methods: Institutional based retrospective cross sectional study was conducted. Data were collected by pre-tested structured checklist. The data were entered into Epi-info version 7 and exported into SPSS version 22.0 for analyses. The association between variables was analyzed using multivariate binary logistic regression analysis. The results were presented using text, tables and figure.Result: Seven hundred eighty four patients were included in this study. Of all study participants, 508 (64.8%) were females. More than half participants 376 (47.96%) were in the age range of (31-45) years. The overall prevalence of treatment failure was 27.48%; of this 12.35% of the participants developed immunologic failure and 4.70% of them had both immunologic and virologic failure. Factors that were significantly associated with treatment failure following multivariable analysis were rural resident [AOR = 3.6; 95% CI (1.11-7.36)], WHO stage III/IV [AOR = 2.7; 95% CI (1.21-5.08)], baseline CD4 count (cells/mm(3)) less than 199 [AOR = 8.11; 95% CI (2.46-19.54)], treatment interruption [AOR = 5.4; 95% CI (2.61-10.45)], poor drug adherence [AOR = 5.9; 95% CI (1.15-12.43)] and TB/HIV co-infection [AOR = 4.6; 95% CI (1.33-12.12).Conclusion: The prevalence of ART failure was higher. Multivariate analysis showed that rural residency, WHO clinical stage III/IV, baseline CD4 count (cells/mm3) less than 200, treatment interruption, poor drug adherence, opportunistic infections and TB/HIV co-infection were significantly associated with treatment failure. (c) 2020 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.