Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

Figures & data

Table 1 Socio-Demographic Characteristics of Children on First-Line ART and Their Caregivers at Public Health Facilities in the West Gojjam Zone from 2016 to 2020

Variable	Category	Cases	Controls	Total
		N (%)	N (%)	N (%)
Sex	Male	57(60.6)	165(59.8)	222(80.4)
	Female	37(39.4)	111(40.2)	148(53.6)
Age group	<5 years	10(10.6)	13(4.7)	23(6.2)
	5–9 years	20(21.3)	55(19.9)	75(20.3)
	≥10 years	64(68.1)	208(75.4)	272(73.5)
Residence	Urban	50(53.2)	162(58.7)	212(57.3)
	Rural	44(46.8)	114(41.3)	158(42.7)
Religion	Orthodox	75(79.8)	261(94.5)	336(90.8)
	Muslim	10(10.6)	9(3.3)	19(5.1)
	Protestant	9(9.6)	6(2.2)	15(4.1)
Caregiver relation	Parents (mother/father)	70(74.5)	226(81.9)	296(80.0)
	Other	16(17.0)	32(11.6)	48(12.9)
	Orphan	8(8.5)	18(6.5)	26(7.1)
Caregiver HIV status	Positive	70(74.5)	223(80.8)	293(79.2)
	Negative	12(12.8)	40(14.5)	52(14.1)
	Unknown	12(12.8)	13(4.7)	25(6.7)
Vital status of the mother	Alive	65(69.1)	191(69.2)	256(69.2)
	Dead	20(21.3)	80(29.0)	100(27.0)
	Do not know	9(9.6)	5(1.8)	14(3.8)
Vital status of the father	Alive	53(56.4)	161(58.3)	214(57.8)
	Dead	31(32.9)	108(39.1)	139(37.6)
	Do not know	10(10.6)	7(2.5)	17(4.6)
Disclosure status	Disclosed	41(43.6)	189(68.5)	230(62.2)
	Non disclosed	53(56.4)	87(31.5)	140(37.8)

Table 2 Laboratory and Clinical Related Informations Among HIV-Infected Children at Public Health Facilities in West Gojjam Zone, Amhara Region, Ethiopia, 2020

Variable	Category	Cases	Controls
		N (%)	N (%)
Recent hemoglobin	<12.5g/dl	48(51.1)	130(47.1)
	≥12.5g/dl	46(48.9)	146(52.9)
Recent CD4	<250 cells/mm3	15(15.9)	57(20.6)
	250–500 cells/mm3	22(23.4)	46(16.6)
	≥500 cells/mm3	57(60.6)	173(62.6)
Baseline viral load result	≤1000 copies/mL	23(24.5)	225(81.5)
	>1000 copies/mL	71(75.5)	51(18.5)
Recent viral load result	≤1000 copies/mL	80(85.1)	214(77.5)
	>1000 copies/mL	14(14.9)	62(22.5)
Functional status for age ≥ 5 years	Working	84(89.4)	253(91.6)
	Ambulatory and bed ridding	10(10.6)	13(4.7)
Developmental status for age < 5 years	Appropriate for the age	9(9.6)	14(5.1)
	Delay and regression	85(90.4)	262(94.9)
Baseline WHO clinical stage	Stage I	32(34.0)	138(50)
	Stage II	23(24.5)	75(27.2)
	Stage III & IV	39(41.5)	63(22.8)
Current TB status	Positive	14(14.9)	6(2.2)
	Negative	80(85.1)	270(97.8)
Opportunistic infections	Yes	28(29.8)	73(26.4)
	No	66(70.2)	203(73.6)
Nutritional status of children	Severe Acute Malnutrition	9(9.6)	3(10.8)
	Moderate Acute Malnutrition	54(57.4)	84(30.4)
	Mild malnutrition	24(25.5)	49(17.8)
	Normal	7(74.5)	140(50.0)

Table 3 HIV Treatment and Drug-Related Characteristics Among HIV-Infected Children at Public Health Facilities in West Gojjam Zone, Amhara Region, Ethiopia, 2020

Variable	Category	Cases	Controls
		N (%)	N (%)
Duration on ART	≤14 months	15(15.9)	7(2.5)
	15–47 months	21(22.3)	64(23.2)
	≥48 months	58(61.7)	205(74.3)
Recent adherence	Good (>95%)	67(71.2)	264(95.7)
	Fair (85–95%)	7(7.5)	5(1.8)
	Poor (<85%)	20(21.3)	7(2.5)
Missed clinical appointment	Yes	56(59.6)	28(10.1)
	No	38(40.4)	248(89.9)
Co-trimoxazole prophylaxis use	Completed	70(74.5)	234(84.8)
	Not completed	24(25.5%)	42(15.2)
Isoniazid prophylaxis use	Completed	70(74.5)	253(91.7)
	Not completed	24(25.5%)	23(8.3)
History of ARV drug change	Yes	75(79.8)	232(84.1)
	No	19(20.2)	44(15.9)
Current regimen	NVP based	19(20.2)	61(22.1)
	EFV based	32(34.1)	101(36.6)
	LPV/R based	43(45.7)	114(41.3)
Reason for ARV regimen change	Drug side effect	25(26.6)	88(31.9)
	New drug availability	69(73.4)	188(68.1)

Abbreviations: BMI, body mass index; b/n, between.

Table 4 Determinants of Virological Failure Among HIV-Infected Children in West Gojjam Zone at Public Health Facilities, 2020

Variable	Category	Cases	Controls	COR (95% CI)	AOR (95% CI)
		(N)	(N)
HIV status disclosure	Disclosed	41	189	1	1
	Not disclosed	53	87	2.81 (1.74,4.54)	4.26 (2.09,8.70)*
Baseline viral load	≤ 1000 copies/mL	23	225	1	1
	> 1000 copies/mL	71	51	13.62 (7.78,23.84)	10.82 (5.40,21.67)*
WHO clinical stage	Stage I	32	138	1	1
	Stage II	23	75	1.322 (0.722,2.422)	1.78 (0.74, 4.27)
	Stage III&IV	39	63	2.58 (1.47,4.55)	2.19 (0.98, 4.91)
Recent adherence	Good	73	264	1	1
	Fair	1	5	0.72 (0.10,6.29)	1.12 (0.03,39.28)
	Poor	20	7	10.33 (4.21,25.39)	6.05 (1.70,21.55)*
Missed clinical appointment	Yes	56	28	13.05 (7.4,23.03)	8.03 (3.88,16.61)*
	No	38	248	1	1

Notes: *Statistically significant at p-value <0.05: 1, is a constant use as a comparison.