College of Health Sciences, Mizan-Tepi University, P.O. BoX 206, Mizan Teferi, Ethiopia.
Departhement of Medical Microbiology college of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Immunol. 2018 Dec 17;19(1):37. doi: 10.1186/s12865-018-0278-4.
The initiation of highly active antiretroviral therapy (HAART) plays a significant role in the clinical management of HIV infected people by preventing morbidity and mortality. This benefit becomes, the most terrible when treatment failure develops. Thus, this research aims to assess the prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia.
Patients on ART with a minimum of 6 months and up to 12 years of treatment were being enrolled. The prevalence of treatment failure, immunological failure and virological failure among people living with HIV/AIDS attending University of Gondar referral hospital were 20.3, 13.2, and 14.7%, respectively. Patients who had no formal education (Adjusted odds ratio (AOR): 3.8; 95% CI, 1.05-13.77), primary level education (AOR: 4.2; 95% CI, 1.16-15.01) and duration on ART < 6 years (AOR: 2.1; 95%CI, 1.12-3.81) were a significant risk factor. However, initial adult regimen D4T + 3TC+ EFV (AOR: 0.025; 95% CI, 0.002-0.36), AZT +3TC + NVP (AOR: 0.07; 95% CI, 0.01-0.71), AZT + 3TC + EFV (AOR: 0.046; 95% CI, 0.004-0.57) andTDF+3TC + EFV (AOR: 0.04; 95% CI, 0.004-0.46) were significantly protective for treatment failure.
Timely and early identification of associated factors and monitoring antiretroviral therapy treatment failure should be done to enhance the benefit and to prevent further complication of the patients. It is preferable to initiate ART using any one of the following ART regimens: AZT +3TC + NVP, AZT + 3TC + EFV and TDF + 3TC + EFV to prevent treatment failure. Since the prevalence of this treatment failure and its associated factor may be different from other ART centers and community in Ethiopia, further national representative institutional based cross-sectional researches are needed across all ART centers of Ethiopia in order to determine the prevalence of treatment failure and its associated factors.
启动高效抗逆转录病毒治疗（HAART）通过预防发病率和死亡率，在 HIV 感染者的临床管理中发挥着重要作用。当治疗失败发生时，这种益处变得最为可怕。因此，本研究旨在评估在衣索比亚西北部贡德尔大学转诊医院接受抗逆转录病毒治疗的 HIV/AIDS 患者中治疗失败的发生率和相关因素。
本研究纳入了至少接受 6 个月、最长达 12 年治疗的 ART 患者。在贡德尔大学转诊医院接受治疗的 HIV/AIDS 患者中，治疗失败、免疫失败和病毒学失败的发生率分别为 20.3%、13.2%和 14.7%。未接受正规教育（调整后的优势比（AOR）：3.8；95%CI，1.05-13.77）、接受初等教育（AOR：4.2；95%CI，1.16-15.01）和 ART 治疗时间<6 年（AOR：2.1；95%CI，1.12-3.81）的患者是显著的危险因素。然而，初始成人方案 D4T+3TC+EFV（AOR：0.025；95%CI，0.002-0.36）、AZT+3TC+NVP（AOR：0.07；95%CI，0.01-0.71）、AZT+3TC+EFV（AOR：0.046；95%CI，0.004-0.57）和 TDF+3TC+EFV（AOR：0.04；95%CI，0.004-0.46）显著降低了治疗失败的风险。
应及时及早识别相关因素并监测抗逆转录病毒治疗失败，以提高患者的受益，并预防进一步的并发症。最好使用以下任何一种 ART 方案启动 ART：AZT+3TC+NVP、AZT+3TC+EFV 和 TDF+3TC+EFV，以预防治疗失败。由于这种治疗失败及其相关因素的流行率可能与埃塞俄比亚其他 ART 中心和社区不同，因此需要在埃塞俄比亚所有 ART 中心进行进一步的全国代表性机构基于横断面研究，以确定治疗失败的流行率及其相关因素。
