Factors Affecting Virological Failure in Children Receiving First-Line Antiretroviral Therapy in Ethiopian Healthcare Facilities: A Retrospective Analysis

Autor: Desalegn M, Shitemaw T, Tesfaye M, Getahun GK
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Pediatric Health, Medicine and Therapeutics, Vol Volume 15, Pp 171-180 (2024)
Druh dokumentu: article
ISSN: 1179-9927
Popis: Mitiku Desalegn,1 Tewoderos Shitemaw,2 Mesfin Tesfaye,3 Genanew Kassie Getahun3 1Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia; 2Menelik II Medical and Health Science College, Addis Ababa, Ethiopia; 3Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa, EthiopiaCorrespondence: Mitiku Desalegn, Email mitikudesalegn44@gmail.comBackground: The causes of virological failure are poorly recognized and investigated. This study aimed to identify determinant factors of viral failure in children taking first-line ART at a randomly selected federal hospital in Addis Ababa, Ethiopia.Methods: A facility-based unmatched case–control study was carried out from May 10, 2022, to July 20, 2022, G.C. among HIV-infected children on first-line antiretroviral therapy. There were 209 HIV-positive youngsters in the study’s overall sample size, comprising 53 cases and 156 controls. Data was gathered by chart review using an organized checklist in English. The data were entered using Epi-data 4.2 and exported into SPSS version 24 for analysis. The relationship between each explanatory variable and the result variable was described using both bivariate and multivariate analysis. An adjusted odds ratio with 95% confidence intervals was conducted, and a p-value < 0.05 was considered statistically significant.Results: Being male (AOR= 4.504; 95% CI: 1.498, 13.539), duration on ART exceeding 47 months (AOR=40.6; 95% CI:9.571,172.222), fair and poor drug adherence (AOR=16.348; 95% CI:4.690,56.990), missed clinical appointments (AOR = 3.177; 95% CI: 1.100– 9.174), and baseline WHO clinical stage 4 disease (AOR = 6.852; 95% CI: 1.540– 30.49) were associated with an increased risk of virological failure. Conversely, a history of drug change and a CD4 count ranging from 250 to 500 cells/mm3 were significantly protective factors (AOR = 0.071; 95% CI: 0.024– 0.214 and AOR=0.118; 95% CI: 0.030, 0.464, respectively).Conclusion: Being male, duration on ART > 47 months, fair and poor adherence, missed clinical appointments, and baseline WHO Stage 4 are factors that increase the odds of virological failure. History of ART Drug change and a CD4 count between 250 and 500 cells/mm3 are factors that decrease the odds of virological failure.Keywords: retrospective, virological failure, antiretroviral therapy, children, Ethiopia
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