First-line antiretroviral treatment failure and associated factors in HIV patients at the University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia

Figures & data

Table 1 Sociodemographic characteristics of HIV/AIDS patients on antiretroviral therapy at UGTH, Northwest Ethiopia, May 2015

Variables	Categories	Frequency (%)
Sex	Female	205 (60.3)
	Male	135 (39.7)
Age (years)	18–30	140 (41.2)
	31–45	173 (50.9)
	46–60	24 (7.1)
	>60	3 (0.9)
Marital status	Never married	52 (15.3)
	Married	171 (50.3)
	Divorced	67 (19.7)
	Widowed	29 (8.5)
	Separated	21 (6.2)
Religion	Orthodox	306 (90)
	Protestant	3 (0.9)
	Muslim	31 (9.1)
Educational status	No education	78 (22.9)
	Primary education	90 (26.5)
	Secondary education	126 (37.1)
	Higher education	46 (13.5)
Substance abuse	No	219 (64.4)
	Yes	121 (35.6)

Abbreviations: UGTH, University of Gondar Teaching Hospital; HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome.

Table 2 Baseline clinical characteristics of HIV/AIDS patients on antiretroviral therapy at UGTH, Northwest Ethiopia, May 2015

Variables	Categories	Frequency (%)
Initial CD4 cell count (cells/mm^3)	<50	23 (6.7)
	50–100	53 (16)
	101–199	98 (29.7)
	200–349	105 (31.8)
	350–500	41 (12.4)
	>500	10 (2.9)
WHO staging at initiation of ART	Stage 1	91 (26.8)
	Stage 2	83 (24.4)
	Stage 3	139 (40.9)
	Stage 4	27 (7.9)
Presence of opportunistic infections	No	180 (52.9)
	Yes	160 (47.1)
Weight (kg)	<35	2 (0.6)
	35–50	142 (41.8)
	51–65	165 (48.5)
	>65	31 (9.1)
Significant comorbid illness	No	308 (90.6)
	Yes	32 (9.4)
Functional status	Working	323 (95)
	Ambulatory	14 (4.1)
	Bed ridden	3 (0.9)
AIDS-defining illness prior to ART	No	180 (52.9)
	Yes	160 (47.1)

Abbreviations: HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome; UGTH, University of Gondar Teaching Hospital, WHO, World Health Organization; ART, antiretroviral therapy.

Table 3 Treatment-related information of HIV/AIDS patients on antiretroviral therapy at UGTH, Northwest Ethiopia, May 2015

Variables	Categories	Frequency (%)
Initial first-line ART regimen	D4T/3TC/NVP	5 (1.5)
	D4T/3TC/EFV	4 (1.2)
	AZT/3TC/NVP	136 (40)
	AZT/3TC/EFV	39 (11.5)
	TDF/3TC/EFV	116 (34.1)
	TDF/3TC/NVP	39 (11.5)
Months on ART	6–12	43 (12.7)
	>12	297 (87.4)
Adherence to first-line regimena	Good	326 (95.5)
	Fair	5 (1.5)
	Poor	9 (2.6)
History of treatment interruption	No	132 (97.6)
	Yes	8 (2.4)
Months of interruption	<6	7 (87.5)
	6–12	1 (12.5)

Note:

a Total doses taken/total doses prescribed ×100: good (>95% adherence level), fair (85%–94% adherence level), and poor (<85% adherence level).

Abbreviations: HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome; UGTH, University of Gondar Teaching Hospital; ART, antiretroviral therapy; NVP, neverapin; EFV, efavirenz; AZT, zidovudine; TDF, tenofovir; D4T, stavudine; 3TC, lamivudine.

Table 4 Treatment failure after initiation of HAART in HIV/AIDS patients at UGTH, Northwest Ethiopia, May 2015

Variables	Categories	Frequency (%)
Presence of treatment failure	No	326 (95.9)
	Yes	14 (4.1)
Type of treatment failure	Virologic failure	12 (85.7)
	Immunologic failure	13 (92.9)
Failing regimen backbone	3TC + AZT	3 (21.4)
	3TC + TDF	11 (78.6)
Months from ART initiation to second-line ART	6–12	6 (42.9)
	>12	8 (57.1)

Abbreviations: HAART, highly active antiretroviral therapy HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome; UGTH, University of Gondar Teaching Hospital; 3TC, lamivudine; AZT, TDF, tenofovir; ART, antiretroviral therapy.

Table 5 Factors associated with first-line ART failure at UGTH, Northwest Ethiopia, May 2015

Variable	Category	Treatment failure, n (%)		OR (95% CI)
		No	Yes	Crude OR (95% CI)	Adjusted OR (95% CI)
WHO stage	Stage 1	91 (27.9%)	0 (0%)	0.00	0.00
	Stage 2	82 (25.2%)	1 (7.1%)	0.05 (0.01–0.48)	0.28 (0.02–4.57)
	Stage 3	131 (40.2%)	8 (57.1%)	0.27 (0.08–0.90)	0.59 (0.09–3.69)
	Stage 4	22 (6.7%)	5 (35.7%)	1.00	1.00
Baseline functional status	Working	311 (95.4%)	12 (85.7%)	1.00	1.00
	Ambulatory	13 (4.0%)	1 (7.1%)	1.99 (0.24–16.51)	0.88 (0.06–13.88)
	Bed ridden	2 (0.6%)	1 (7.1%)	12.96 (1.10–153.00)	0.17 (0.00–17.67)
Baseline CD4 count (cells/mm^3)	<50	16 (5.1%)	7 (50%)	1.00	1.00
	50–100	49 (15.5%)	4 (28.6%)	0.19 (0.05–0.72)	0.11 (0.02–0.72)a
	101–200	95 (30.1%)	3 (21.4%)	0.07 (0.02–0.31)	0.06 (0.01–0.45)a
	>200	180 (49.4%)	0 (0%)	0.00	0.00
Treatment interruption	No	319 (97.9%)	12 (85.7%)	1.00	1.00
	Yes	7 (2.1%)	2 (14.3%)	7.60 (1.42–40.50)	3.75 (0.05–288.73)
Drug adherence	Good	317 (97.2%)	9 (64.3%)	1.00	1.00
	Fair	5 (1.5%)	0 (0%)	0.00	0.00
	Poor	4 (1.2%)	5 (35.7%)	44.02 (10.10–191.92)	70.54 (5.57–893.86)a
Opportunistic infections	No	241 (73.9%)	2 (14.3%)	1.00	1
	Yes	85 (26.1%)	12 (85.7%)	17.01 (3.73–77.57)	5.48 (0.79–38.00)

Note:

a Has significant association.

Abbreviations: ART, antiretroviral therapy; UGTH, University of Gondar Teaching Hospital; OR, odds ratio; CI, confidence interval; WHO, World Health Organization.