Treatment Failure among People living with HIV taking Antiretroviral Therapy in Ethiopia

Background Although treatment failure (TF) among population on antiretroviral therapy (ART) become a major public health threat, its magnitude of and factors leading to it are poorly defined. Hence, we aimed to estimate the magnitude of TF and its determinants in Ethiopia. Methods A follow-up study was conducted from March 2016 to 2017. Clinical and laboratory data were captured from paticipants’ medical record. Socio-demographics and explanatory variables were collected using structured questionnaire. Participants with baseline viral load (VL) >1000 copies/ml were followed for three to six month to clasify virologic failure (VF). Logistic regression was conducted to assess associated risk factors and statistical significance was set at P-value < 0.05. Results A total of 9,284 adults from 63 health facilities were included in the study.Viral load suppression (VLS) were found to be 8,180 (88.1%). Thirty-five percent of the study participants with VL>1000 copies/ml at baseline of the study were re-suppressed after three to six month of adherence counseling and hence VF was found to be 983 (11%). Immunologic and clinical failure was significantly improved from 21.5% and 16.5% at ART initiation to 576 (6.2%) and 470 (5.0%) at baseline of the study, respectively. Adherence, disclosure of HIV status, missed appointment to ART, history of ART exposure prior to initiation, residency and marital status had significant association with VLS. Conclusions VLS (88.1%) could explain the success of ART program in Ethiopia towards the UNAIDS global target. Eleven percent of the population is maintained on a failed first-line regimen. Improving adherence, ensuring disclosure of HIV status and appointment follow-up could improve treatment outcome.