Prevalence and Predictors of Immunological Treatment Failure among HIV Infected Adults on the First-line Antiretroviral Therapy in Mbeya Region, Tanzania

¹School of Public Health, the Catholic University of Health and Allied Sciences

²Department of Paediatrics and Child Health, Bugando Medical Centre

³Department of Biochemistry, Catholic University of Health and Allied Sciences

Corresponding Author: Erasmus Kamugisha, Department of Biochemistry, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania, E-Mail: [email protected]

Received Date: 02 Nov 2017  
Accepted Date: 03 Jan 2018  
Published Date: 05 Jan 2018

Copyright © 2018 Kamugisha E

Citation: Kamugisha E, Chomboko CL, Kabyemera RM, and Kidenya BR. (2018). Prevalence and Predictors of Immunological Treatment Failure among HIV Infected Adults on the First-line Antiretroviral Therapy in Mbeya Region, Tanzania. Mathews J HIV AIDS. 3(1): 017

ABSTRACT

Background: Immunological treatment failure (ITF) is a common challenge among HIV-infected patients on first-line ART in resource-limited settings. This study aimed to determine the magnitude of ITF and its predictors among adult HIV-infected patients on ART in Mbeya Region, Tanzania.

Methods: This was a cross-sectional, retrospective study which analyzed data of HIV-infected patients (= 15years) on ART. Data were collected from patients enrolled at health facilities in Mbeya region from January 2010 to June 2016. Data were obtained from the HIV care and treatment clinic (CTC) electronic database and patients’ CTC - 2 cards and were analyzed to determine the factors influencing the ITF.

Results and discussion: A total of 2,565patients’ records were reviewed and followed retrospectively for a median duration of 24.5[13.6-43.6] months. Of this 64.4 % (1653/2,565) were female and the median age was 41 (IQR: 35-48) years. The median baseline CD4 count was 194 (IQR: 92-344) cells/μl. ITF was reported in 42.8% (1237/2,565) patients. There was a significant association between ITF and baseline CD4 of ≥350cell/µl (OR = 7.2, 95%CI = 5.7 – 9.2, p < 0.001), increased age(OR = 1.01, 95% CI =1.002 – 1.020], p = 0.012) p = 0.012), being the patient from district council designated hospital (OR = 1.2, 95%CI =1.1 – 1.5, p = 0.008), hemoglobin < 8g/dL (OR = 1.4, 95%CI 1.1 – 1.8, p = 0.017),, longer duration from HIV diagnosis to ART

Conclusion: There was a high prevalence of immunological treatment failure. Significant predictors of ITF were age, baseline CD4 of ≥ 350cell/µl,, being patient from the district hospital, anemia, longer duration from HIV diagnosis to ART initiation and AZT-based ART regimen. Health care providers should be guided to focus on predictors of immunological failure so that they do early switching to second-line ART.

KEYWORDS

Prevalence of Immunological Failure; Treatment Failure; ART; Mbeya; Tanzania.