HIV Case Detection, Treatment and Care, Woliso Health Center, Waliso, Ethiopia.
Department of Public Health, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia.
AIDS Res Ther. 2024 Jun 24;21(1):42. doi: 10.1186/s12981-024-00625-4.
Ethiopia's viral suppression rate was less than 90% by 2020, and more than 10% of adult clients on ART in Woliso Town were unsuppressed at the end of March 2022. This study aims to identify determinants of virologic failure among adult clients on ART at health facilities in Oromia region of Ethiopia.
A facility-based unmatched case-control study was conducted at health facilities in Oromia region from August 1 to September 1, 2022. The study cases were clients with virologic-confirmed first-line ART failure, while controls were clients on first-line ART with a suppressed viral load. A total of 135 cases and 268 control participants were selected using simple random sampling techniques, and data were collected by reviewing the client's document. Epi-Info7 was used for data entry and SPSS version 20 for data analysis. Variables having a P-value of less than 0.25 in the bi-variable analysis were included in multivariable logistic regression. Determinants of virologic failure were determined based on an adjusted odds ratio using 95% CI and a P-value of < 0.05.
In this study, clients with an age ≥ 35 years (AOR = 3.4, 95% CI: 1.6, 7.0), clients with a baseline regimen of AZT + 3TC + NVP (AOR = 3.5, 95% CI: 1.4, 8.8), clients with a base-line CD4 count < 350 mm (AOR = 2.3, 95% CI: 1.1, 4.5), being single marital status (AOR = 3.7, 95% CI: 1.4, 10.5), TB-HIV coinfection (AOR = 2.58, 95% CI: 1.3, 5.1), and having opportunistic infection other than TB in the last six months (AOR = 3.06, 95% CI: 1.5, 6.3) were factors significantly associated with virologic failure while clients within the appointment spacing model (AOR = 0.05, 95% CI: 0.03, 0.10) is inversely associated with virologic failure.
This study showed that age ≥ 35 years, being single, baseline ART regimen with (AZT + 3TC + NVP), baseline CD4 cell count < 350 mm, Tb-co infection, and opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement in the appointment spacing model was found to be protective.
2020 年以前，埃塞俄比亚的病毒抑制率不到 90%，2022 年 3 月底，沃尔索镇接受抗逆转录病毒治疗（ART）的成年患者中，超过 10%的患者病毒未得到抑制。本研究旨在确定奥罗米亚地区卫生机构接受 ART 的成年患者病毒学失败的决定因素。
2022 年 8 月 1 日至 9 月 1 日，在奥罗米亚地区的卫生机构进行了一项基于设施的不匹配病例对照研究。该研究的病例为经病毒学确认的一线 ART 治疗失败的患者，而对照组为病毒载量得到抑制的一线 ART 治疗患者。采用简单随机抽样技术，共选择了 135 例病例和 268 例对照参与者，并通过查阅患者的病历收集数据。使用 Epi-Info7 进行数据录入，使用 SPSS 版本 20 进行数据分析。在双变量分析中 P 值小于 0.25 的变量被纳入多变量逻辑回归。根据 95%CI 和 P 值<0.05 的调整后比值比，确定病毒学失败的决定因素。
在这项研究中，年龄≥35 岁的患者（AOR=3.4，95%CI：1.6，7.0）、基线方案为 AZT+3TC+NVP 的患者（AOR=3.5，95%CI：1.4，8.8）、基线 CD4 计数<350mm 的患者（AOR=2.3，95%CI：1.1，4.5）、单身的患者（AOR=3.7，95%CI：1.4，10.5）、合并结核-艾滋病毒感染的患者（AOR=2.58，95%CI：1.3，5.1）、过去六个月有机会性感染（除结核病外）的患者（AOR=3.06，95%CI：1.5，6.3）与病毒学失败显著相关，而在预约间隔模型内的患者（AOR=0.05，95%CI：0.03，0.10）与病毒学失败呈负相关。
本研究表明，年龄≥35 岁、单身、基线 ART 方案为（AZT+3TC+NVP）、基线 CD4 细胞计数<350mm、合并结核感染以及过去 6 个月内发生机会性感染与病毒学失败相关。参与预约间隔模型被发现具有保护作用。
