ArticleSAGE open medicine2025
Time to virological failure and its predictors among children receiving first-line antiretroviral treatment in selected public Hospitals, Eastern Ethiopia, 2022: A multicenter retrospective cohort study.
Article in SAGE open medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The World Health Organization recommends the viral load test as the preferred method for monitoring responses to antiretroviral treatment; however, this test is not widely available in developing countries. Timely monitoring is crucial; early detection of virological failure can significantly improve health outcomes for these children and help prevent the development of drug resistance. Therefore, this study aims to contribute valuable insights into time to virological failure and its predictors among children with human immunodeficiency virus. Methods: An institution-based retrospective follow-up study was conducted among 497 children who were enrolled for first-line antiretroviral treatment from January 1, 2017 to December 31, 2021 in Eastern Ethiopia public Hospitals. A standard pretested checklist was used to extract data. Data were entered using Epi-Data 4.6 and analyzed using STATA 16. Kaplan-Meier was used to estimate the cumulative probability of virological failure, and the log-rank test was used to compare failure curves. The Cox proportional hazard regression model was used to analyze the relationship between independent and outcome variables. Results: The overall incidence rate of virological failure was 3.70/1000 person-month observations (95% confidence interval: 2.88-4.76). World Health Organization clinical stages 3 and 4 at the time of antiretroviral treatment beginning (adjusted hazard ratio: 2.38 (95% confidence interval: 1.34-4.26)), baseline cluster of differentiation 4 cells, type of T lymphocytes count below the threshold (adjusted hazard ratio: 3.65 (95% confidence interval: 2.12-6.30)), tuberculosis positive during the follow-up period (adjusted hazard ratio: 4.81 (95% confidence interval: 2.51-9.23)), and poor adherence to the antiretroviral treatment regimen (adjusted hazard ratio: 3.87 (95% confidence interval: 2.08-7.22)) were independent predictors of virological failure. Conclusion: The incidence of virological failure in this area was significantly higher compared to nationally conducted studies in Ethiopia. Baseline World Health Organization clinical stages 3 and 4, baseline cluster of differentiation 4 cells, type of T lymphocytes level below the threshold, being tuberculosis infected during the follow-up, and poor adherence were identified as independent predictors of time to virological failure.
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