Abstract:
Background: Despite the wide spread availability of antiretroviral therapy, Immunological and clinical failure had shown high in some African countries. However, few studies have assessed the prevalence of Virologic failure in Ethiopia. The results of this study will reinforce early detection and prevention of Virologic failure.
Objective:To determine prevalence of Virologic failure and its predictors among patients on antiretroviral therapy .
Method: A cross-sectional study was conducted in Debre-Berhan town anti-retroviral therapy providing health institutions, North Shoa Zone from February to March 2020.
Systematic random samplingtechnique was used to include a sample of 432 study subjects with their charts. An interviewer-administered structured questionnaire and data extractor checklist for chart review were used to collect information. The collected data were entered to Epidata version 3.1 and exported to SPSS packages version 21 for analysis. Stepwise conditional logistic for variable selection with p-value <0.1. The final model was assessed for goodness of fit using the Hosmer-Lemeshow test, % classified,
Area under Roc curve(AUC) and multiple logistic regression by backward elimination
techinques analysis were performed to determine independent predictors that have
significant association with the Virologic failure.Significant association was considered with p<0.05.
Result:A total 420 participants were involed in the study with response rate of 99.3%.The median age of participants was 40 years with (inter quartile range [IQR]:35-48 years.More than half (54.5%) of study subjects were females. The prevalence of virologic failure was 79(18.8%) (95%CI:15.06, 22.56). Baseline CD4count(AOR=2.67,95%CI:1.14, 6.28), ART interruption(AOR=6.5,95%CI:2.6, 16.5), viral rebound(AOR=3.36, 1.21, 95%CI:1.2,9.3)membership in social group(AOR=0.17, 95%CI: 0.057, 0.55), Having Sexualy transmitted infections (AOR=4.4, 95%CI:1.9,10), dyspepsia(AOR= 7.6, 95%CI: 3,19.8), Hypertension and diabetes (AOR=6.8, 95%CI: 2.5,18.2), Nevirapine base regimen(AOR=2.46, 95%CI:1.4, 5.85) were independent predictors of Virologic failure.
Conclusion and recommendation: Prevalence of Virologic failure was high, more than10%WHO cut of point. Strong support should be established for all patients on antiretroviral therapyby local support groups, councilors andhealth care works.