Abuhay Habtamu Wagnew, Endalew Tizazu, Birhan Tilahun Yemanu, Muche Achenef Asmamaw
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
University of Gondar Compressive Specialized Hospital, Gondar, Ethiopia.
HIV AIDS (Auckl). 2024 May 2;16:183-192. doi: 10.2147/HIV.S455885. eCollection 2024.
Second-line antiretroviral treatment failure has become a major public health issue, and the time to treatment failure among second-line ART clients varies globally, and the Sub-Saharan African region having a high rate of second-line ART treatment failures. In addition, after the ART treatment guideline changed there is limited information on Ethiopia. Therefore, this study aimed to assess time to treatment failure and its determinants among second-line ART clients in Amhara Region, Ethiopia.
A multi-centered retrospective follow-up study was conducted. A random sample of 860 people on second-line ART was selected by using a computer-generated simple random sampling technique from January 30, 2016, to January 30, 2021, at the University of Gondar Compressive Specialized Hospital, Felege Hiwot Compressive Specialized Referral Hospital, and Debre Tabor Compressive Specialized Referral Hospital, in Amhara region, Ethiopia. Data was captured using a checklist.
A total of 81 (9.4%) ART clients developed second-line treatment failure, with a median follow-up time of 29 months with an interquartile range (IQR: 18, 41]. The risk of second-line treatment failure is higher among patients aged 15 to 30 years (adjusted hazard ratio (AHR) = 2.01, 95% confidence interval (CI): [1.16, 3.48]). Being unable to read and write (AHR = 1.312, 95% CI: [1.068, 1.613]), and poor ART drug adherence (AHR = 3.067, 95% CI: [1.845, 5.099]) were significant predictors of second-line ART treatment failures.
In the current study, the time to second-line ART treatment failure was high compared with a previous similar study in Ethiopia. Factors like being younger age, ART clients who are not being able to read and write, and having poor ART drug adherence was significant predictors of second-line ART treatment failure.
二线抗逆转录病毒治疗失败已成为一个重大的公共卫生问题，二线抗逆转录病毒治疗患者的治疗失败时间在全球范围内各不相同，撒哈拉以南非洲地区二线抗逆转录病毒治疗失败率很高。此外，抗逆转录病毒治疗指南变更后，埃塞俄比亚的相关信息有限。因此，本研究旨在评估埃塞俄比亚阿姆哈拉地区二线抗逆转录病毒治疗患者的治疗失败时间及其决定因素。
进行了一项多中心回顾性随访研究。采用计算机生成的简单随机抽样技术，于2016年1月30日至2021年1月30日在埃塞俄比亚阿姆哈拉地区的贡德尔大学综合专科医院、费莱格希沃特综合专科医院转诊医院和德布雷塔博尔综合专科医院转诊医院，随机抽取了860名接受二线抗逆转录病毒治疗的患者。数据通过检查表收集。
共有81名（9.4%）抗逆转录病毒治疗患者出现二线治疗失败，中位随访时间为29个月，四分位间距为（IQR：18，41）。15至30岁患者二线治疗失败的风险更高（调整后风险比（AHR）=2.01，95%置信区间（CI）：[1.16，3.48]）。不识字（AHR = 1.312，95% CI：[1.068，1.613]）和抗逆转录病毒药物依从性差（AHR = 3.067，95% CI：[1.845，5.099]）是二线抗逆转录病毒治疗失败的重要预测因素。
在本研究中，与埃塞俄比亚之前的类似研究相比，二线抗逆转录病毒治疗失败的时间较高。年龄较小、不识字的抗逆转录病毒治疗患者以及抗逆转录病毒药物依从性差等因素是二线抗逆转录病毒治疗失败的重要预测因素。
