Rate and predictors of HIV virological failure among adults on first-line antiretroviral treatment in Dar Es Salaam, Tanzania

  • Florence George Samizi Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania
  • Onna Duuma Panga Geita Regional Health Management Team, Geita, Tanzania
  • Senga Sembuche Mulugu Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
  • Catherine Gale Gitige Kibong’oto Infectious Diseases Hospital, Kilimanjaro, Tanzania
  • Elia John Mmbaga Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
Keywords: First line antiretroviral drugs, HIV, Virological failure, Predictors, Tanzania

Abstract

Introduction: Monitoring resistance to first line Antiretroviral therapy (ART) is crucial in preventing accumulation of viral mutations following the implementation of the World Health Organization “treat all” initiative. We estimated the rate and predictors of virological treatment failure among adults living with HIV/AIDS in Dar es Salaam, Tanzania.

Methodology: A retrospective cohort study involving adults aged 18 and above receiving first line ART in Dar as Salaam between 2016 and 2018 were recruited using multistage random sampling. Clinical and laboratory data were extracted from Care and Treatment Clinic database-2 (CTC2) followed by participant’s interviews. Adjusted Cox-regression modelling was used to determine independent predictors of treatment failure.

Results: A total of 340 participants with mean age of 37 were recruited. Overall, 10.59% had virological failure and the rate of failure was 5.24 (95% CI:3.72; 7.27) per 100 person-months at risk with a median failure time of 18 months. Independent predictors of treatment failure were being a male (Adjusted hazard ratio (aHR) 2.78, 95%CI:1.16;6.63), having used treatment for less than two years (aHR, 12.48, 95%CI:3.64-22.71) and co-infection with Tuberculosis (aHR 2.1, 95%CI: 1.0;5.9).

Conclusions: HIV virological failure occurs early during treatment in this population. Male clients, co-infected with Tuberculosis were at higher risk of ART failure within two years of treatment. Substantial stride has been made towards the achievement of the last UNAIDS 90 goal but tailored counseling and close monitoring of HIV/TB co-infected male clients following ART initiation could accelerate efforts to close the gap. Further studies on pre-treatment drug resistance mutations are called for.

Published
2021-06-30
How to Cite
1.
Samizi FG, Panga OD, Mulugu SS, Gitige CG, Mmbaga EJ (2021) Rate and predictors of HIV virological failure among adults on first-line antiretroviral treatment in Dar Es Salaam, Tanzania. J Infect Dev Ctries 15:853-860. doi: 10.3855/jidc.13603
Section
Original Articles