ArticleJournal of public health research2025
Viral failure and associated factors in adults on second line antiretroviral therapy in public hospitals of Harari Region and Dire Dawa administration, Eastern Ethiopia.
Article in Journal of public health research, 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
Background: Virological failure in second-line antiretroviral therapy (ART) occurs when HIV patients have a viral load exceeding 1000 copies/ml, presenting significant public health challenges, including increased risk of transmission of HIV, heightened morbidity and mortality rates, and the risk of developing drug resistance. The extent of virological failure among second-line ART patients in the Harari region and Dire Dawa city of Eastern Ethiopia has not been thoroughly investigated. This study aimed to determine the prevalence of virological failure and its influencing factors from January 1 to December 31, 2023. Design and methods: A cross-sectional study was conducted among 478 adult second-line antiretroviral therapy users at an institution-based setting. A census was employed to recruit the study participants. Data was collected using a semi-structured data extraction checklist entered into EpiData version 4.6 and exported to SPSS version 26 for analysis. Descriptive statistics, along with bivariable and multivariable logistic regression analyses, were performed to determine the associations between virological failure and independent variables, using adjusted odds ratios with 95% confidence intervals. A Results: The overall prevalence of virological failure among adult second-line ART users was 12.76% (95% CI = 10.05-16.07). Smoking (AOR = 2.81), BMI status (AOR = 6.97), TB-HIV co-infection (AOR = 0.20), history of INH prophylaxis (AOR = 4.25), and enhanced ART adherence counseling (AOR = 7.02) were found to be significantly associated with virological failure among second-line ART users. Conclusion: Nearly 1 in 10 adults on second-line ART experienced virological failure. Factors such as smoking, nutritional status, TB-HIV co-infection, and adherence counseling significantly influenced outcomes. Continuous monitoring and clinical interventions are crucial to reduce virological failures in this population.
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