Author:
Alemayehu Tinsae,Abebe Workeabeba
Abstract
AbstractSub-Saharan Africa carries the largest burden of pediatric HIV infection. The success of second line anti-retroviral treatment and related factors among African children is not well-defined. Objectives: We aimed to identify the rate and determinants of second line anti-retroviral treatment failure among children and adolescents on follow-up at an Ethiopian tertiary teaching hospital. A retrospective observational cohort study was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa. Structured forms were used to collect socio-demographic, clinical and diagnostic data. Descriptive statistics and bivariate analysis were used to describe the magnitude of the problem and its associations. A total of 76 children and adolescents taking second line anti-retroviral treatment were analyzed (mean age: 16.1 years). Failure of therapy was seen in 14/76 while four were eligible for a switch to third line anti-retrovirals. Mean duration on second line treatment till virologic failure was diagnosed was 17.6 months while mean viral load upon requiring a third line regimen was 82,131.3 copies/ml. Second line antiretroviral treatment virologic failure was significantly associated with the age of the child or adolescent. A high rate of virologic failure exists among the study population. Findings underline need for provision of third line anti-retroviral drugs in Ethiopia. Challenges for delivering a standard care were irregular viral load testing and delayed initiation of second line treatment after failure of first line regimens.
Publisher
Springer Science and Business Media LLC
Reference19 articles.
1. Getnet, Y. Determinants of first line anti-retroviral treatment failure in public hospitals of Addis Ababa, Ethiopia: Unmatched case control study. Journal of Biology, Agriculture & Healthcare 4(15), 1–13 (2014).
2. Bayou, B., Sisay, A. & Kumie, A. Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV infected patients in St Luke and Tulubolo Hospital, Oromia region. Ethiopia. Pan African Medical Journal; 21(291), 1–10, https://doi.org/10.11604/pamj.2015.21.291.6831 (2015).
3. Yimer, Y. T. & Yalew, A. W. Magnitude and predictors of ART failure in private health facilities in Addis Ababa, Ethiopia. PLoS ONE 10(5), 1–17, https://doi.org/10.1371/journal.pone.0126026 (2015).
4. Biset, M. et al. First line anti-retroviral treatment failure and associated risk factors in HIV patients at the University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia. HIV/AIDS Research and palliative care 8, 141–146, https://doi.org/10.2147/HIV.S112048 (2016).
5. Yassin, S. & Gebretekle, G. B. Magnitude and predictors of ART failure among HIV-infected children in Fiche and Kuyu hospitals, Oromia region, Ethiopia: a retrospective cohort study. Pharma res per 5(1), 1–9, https://doi.org/10.1002/prp2.296 (2017).