Bisetegn Getachew, Arefaynie Mastewal, Mohammed Anissa, Fentaw Zinabu, Muche Amare, Dewau Reta, Seid Yimer
Dessie City Zonal Health Department, CDC-Ethiopia, Dessie, Ethiopia.
Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
HIV AIDS (Auckl). 2021 Jan 26;13:91-97. doi: 10.2147/HIV.S290531. eCollection 2021.
HIV virological failure is a common challenging problem, even after adherence-enhancement counseling. However, there have been few studies on the determinants of virological failure after adherence-enhancement counseling among adult patients on antiretroviral therapy in Ethiopia in general, and there is variation across clients and settings for unknown reasons. Therefore, this study aimed to identify predictors of virological failure after adherence-enhancement counseling among adults living with HIV/AIDS.
A case-control study was conducted in the town of Kombolcha from January 1, 2019 to March 30, 2019 using simple random sampling for 338 participants. Data were collected through face-to-face interviews for social and personal characteristics and document review for clinical profiles. Descriptive statistics were used for frequency, proportions, and summary measures. Binary logistic regression analysis was carried out to identify the predictors of virological failure after adherence-enhancement counseling among adults. For multivariate logistic regression,<0.05 was considered statistically significant. AORs are presented with 95% CIs.
The odds of virological failure after adherence-enhancement counseling were higher following poor antiretroviral medication adherence (AOR 7.3, 95% CI 2.57-20.79) and for patients who had had a first high viral load (≥10,000 copies/mL, (AOR 5, 95% CI 1.86-13.56) and a history of opportunistic infection (AOR 3.7, 95% CI 1.11-8.44) compared with their counterparts.
Poor antiretroviral medication adherence during adherence-enhancement counseling session, first viral load ≥10,000 copies/mL, and recent history of opportunistic infection were predictors of virological failure. Therefore, efforts should be strengthened to improve adherence to antiretroviral medication, which helps to boost immunity and suppress viral replication.
即使在进行了强化依从性咨询之后，HIV病毒学治疗失败仍是一个常见的棘手问题。然而，总体而言，埃塞俄比亚接受抗逆转录病毒治疗的成年患者在强化依从性咨询后病毒学治疗失败的决定因素方面的研究很少，并且在不同患者和环境中存在不明原因的差异。因此，本研究旨在确定HIV/AIDS成年患者在强化依从性咨询后病毒学治疗失败的预测因素。
2019年1月1日至2019年3月30日在孔博尔查镇进行了一项病例对照研究，采用简单随机抽样选取了338名参与者。通过面对面访谈收集社会和个人特征数据，并通过文件审查获取临床资料。描述性统计用于频率、比例和汇总指标。进行二元逻辑回归分析以确定成年患者在强化依从性咨询后病毒学治疗失败的预测因素。对于多变量逻辑回归，<0.05被认为具有统计学意义。调整后的比值比（AOR）以95%置信区间（CI）表示。
与对照组相比，抗逆转录病毒药物依从性差（AOR 7.3，95% CI 2.57 - 20.79）、首次病毒载量高（≥10,000拷贝/mL，AOR 5，95% CI 1.86 - 13.56）以及有机会性感染史（AOR 3.7，95% CI 1.11 - 8.44）的患者在强化依从性咨询后病毒学治疗失败的几率更高。
在强化依从性咨询期间抗逆转录病毒药物依从性差、首次病毒载量≥10,000拷贝/mL以及近期有机会性感染史是病毒学治疗失败的预测因素。因此，应加强努力以提高对抗逆转录病毒药物的依从性，这有助于增强免疫力并抑制病毒复制。
