Incidence and Predictors of Virological Failure Among Adult HIV/AIDS Patients on Second-Line Anti-Retroviral Therapy, in Selected Public Hospital of Addis Ababa, Ethiopia: Retrospective Follow-Up Study

Figures & data

Figure 1 Proportional allocation of sample size among selected public hospitals in Addis Ababa, Ethiopia.

Figure 2 Kaplan–Meier survival function of the virological failure of HIV/AIDS patients on second-line ART at public hospitals of Addis Ababa Ethiopia, September 2018 to January 2021.

Figure 3 Plot of Nelson-Aalen cumulative hazard function against Cox–Snell residual for the virological failure of HIV/AIDS patients on second-line ART at public hospitals of Addis Ababa Ethiopia, September 2018 to January 2021.

Table 1 Sociodemographic Characteristics of Patients on Second-Line ART at Public Hospitals of Addis Ababa Ethiopia, September 2018 to January 2021

Variables	Category	Frequency	Percent (%)
Age (years)	15–29	56	15.56
	30–45	185	51.39
	> 45	119	33.06
Sex	Male	162	45.00
	Female	198	55.00
Religion	Orthodox	281	78.06
	Muslim	29	8.06
	Protestant	48	13.33
	Catholic	2	0.56
Marital status	Single	112	31.11
	Married	139	38.61
	Divorced	60	16.67
	Widowed	40	11.11
	Separated	9	2.50
Educational level	No formal education	51	14.17
	Primary	126	35.00
	Secondary	128	35.56
	Tertiary	55	15.28
Occupational status	Government Employed	33	9.17
	Non-government Employed	181	50.28
	Jobless	48	13.33
	Student	44	12.22
	Housewife	46	12.78
	Other*	8	2.22

Note: *Other: driver, daily labor.

Table 2 Characteristics of Patients During Switching and After Switched to Second-Line ART at Public Hospitals of Addis Ababa Ethiopia, September 2018 to January 2021

Variables	Category	Frequency	Percent (%)
NRTI backbone at switch	AZT + 3TC	112	31.11
	TDF + 3TC	239	66.39
	Other	9	2.50
Number of times first-line regimen changed	No change	247	68.61
	One change	94	26.11
	Two and more than two change	19	5.28
Second-line regimen	LPV/r based	30	8.33
	ATV/r based	330	91.67
BMI at switch	Normal	245	68.06
	Mild	89	24.72
	Moderate	26	7.22
TB Co-infection	No	318	88.33
	Yes	42	11.67
CD4 at switch	<100 cells/mm^3	154	42.78
	≥ 100 cells/mm^3	206	57.22
WHO stage at the switch	Stage I/II	271	75.28
	Stage III	52	14.44
	Stage IV	37	10.28
Adherence at switch	Good/Fair (≥85%)	302	83.89
	Poor (<85%)	58	16.11
Functional status at switch	Working	297	82.50
	Ambulatory	49	13.61
	Bedridden	14	3.89
Opportunistic infection	No	299	83.06
	Yes	61	16.94
Adverse reaction	No	276	76.67
	Yes	84	23.33
Alcohol use	No	327	90.83
	Yes	33	9.17

Abbreviations: BMI, body mass index; NRTI, nucleoside reverse transcriptase inhibitors.

Table 3 Uni-Variable and Multivariable Cox Proportional Hazard Model for Predictors of Virological Failure Among HIV Patients on Second-Line ART at Public Hospitals of Addis Ababa Ethiopia, September 2018 to January 2021

Variables	Category	Event	Censored	CHR (95% CI)	AHR (95% CI)
Age (years)	15–29	9	47	1	1
	30–45	18	167	0.58 (0.26, 1.27)	0.53 (0.20, 1.37)
	>45	17	102	0.83 (0.37, 1.85)	0.36 (0.12, 0.99)*
Educational level	No formal education	17	34	1	1
	Primary	13	113	0.30 (0.14, 0.60)*	0.93 (0.28, 3.06)
	Secondary	11	117	0.24 (0.11, 0.52)*	0.48 (0.15, 1.47)
	Tertiary	3	52	0.15 (0.04, 0.52)*	0.29 (0.06, 1.39)
Number of times first-line regimen changed	None	17	230	1	1
	One	21	73	3.35 (1.77, 6.34)*	2.21 (0.98, 4.94)
	Two and more than two	6	13	5.00 (1.97, 12.69)*	1.67 (0.41, 6.82)
WHO stage at the switch	Stage I/II	23	248	1	1
	Stage III	10	42	2.27 (1.10, 4.76)*	0.28 (0.07, 1.11)
	Stage IV	11	26	3.76 (1.83, 7.72)*	0.41 (0.11, 1.44)
BMI	Normal	7	238	1	1
	Mild	24	65	10.63 (4.58, 24.69)*	2.58 (0.78, 8.49)
	Moderate	13	13	20.30 (8.10, 50.90)*	3.58 (0.68, 18.66)
Baseline hemoglobin	Non-anaemic	24	237	1	1
	Moderate	13	39	2.70 (1.40, 5.30)*	0.91 (0.36, 2.28)
	Severe	6	6	6.00 (2.45, 14.69)*	1.02 (0.23, 4.59)
Functional status at the switch	Working	20	277	1	1
	Ambulatory	18	31	6.15 (3.25, 11.63)*	2.39 (0.80, 7.19)
	Bedridden	6	8	7.13 (2.86, 17.76)*	1.41 (0.24, 8.40)
OI	Yes	15	46	1	1
	No	27	270	0.38 (0.20, 0.71)*	1.55 (0.63, 3.84)
CD4 count at switch	≥100 cells/mm^3	9	197	1	1
	<100 cells/mm^3	35	119	5.60 (2.70, 11.65)*	3.02 (1.17, 7.78)*
TB Co-infection	No	18	300	1	1
	Yes	26	16	14.19 (7.76, 25.9)*	2.48 (1.10, 6.33)*
Second line regimen	LPV/r based	12	18	1	1
	ATV/r based	32	298	0.19 (0.10, 0.38)*	0.27 (0.11, 0.70)*
Adherence level at the switch	Good/Fair (≥85%)	12	290	1	1
	Poor (<85%)	32	26	18.19 (9.35, 35.38)*	6.18 (1.93, 19.76)*
History of adverse drug reaction	Yes	20	64	1	1
	No	24	252	0.36 (0.20, 0.64)*	0.94 (0.45, 1.96)
Alcohol Use	Yes	26	301	1	1
	No	18	15	8.144.45, 14.86)*	0.69 (0.28, 1.72)

Note: *Significant at p-value<0.05.

Abbreviations: AZT, azidothymidine; TDF, tenofovir disoproxil fumarate; OI, opportunistic infection; BMI, body mass index.