ArticleAIDS research and therapy2026
Determinants of virologic failure among adult HIV patients on first-line antiretroviral therapy in health facilities of Awi Zone, northwest Ethiopia: a case-control study.
Article in AIDS research and therapy, 2026. 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
backgroundViral load is the most reliable indicator of antiretroviral therapy response and treatment failure. In Ethiopia, virologic failure remains a major challenge despite expanded ART coverage.
objectiveTo identify determinants of virologic failure among adults on first-line antiretroviral therapy in health facilities of Awi Zone, Northwest Ethiopia.
methodsAn institution-based unmatched case-control study with a 1:2 ratio was conducted among 369 participants (123 cases and 246 controls). Cases were HIV-infected clients aged ≥ 15 years with virologic failure (viral load > 1000 copies/mL on two consecutive tests after adherence support) between 30 October 2020 and 30 December 2024. Controls were HIV-infected clients aged ≥ 15 years on first-line ART with viral load ≤ 1000 copies/mL on two consecutive tests after ≥ 6 months of treatment during the study period. Participants were selected using computer-generated simple random sampling from selected facilities. Bivariable and multivariable binary logistic regression analyses were performed to identify independent determinants of virologic failure.
resultsMultivariable analysis identified non-disclosure of HIV status (AOR = 2.24, 95% CI: 1.11-5.22), viral load after ART initiation > 1000 copies/mL (AOR = 5.32, 95% CI: 3.32-7.15), poor treatment adherence (AOR = 5.64, 95% CI: 2.01-7.32), treatment interruption (AOR = 6.45, 95% CI: 3.95-14.01), being single (AOR = 2.34, 95% CI: 1.54-5.32), and CD4 count < 200 cells/mm³ (AOR = 4.90, 95% CI: 2.40-8.25) as significant determinants of virologic failure.
conclusionStrengthening adherence support, retention in care, and disclosure counseling is essential to reduce virologic failure.
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