Abstract:

Background: Antiretroviral therapy is a proven medication given for Human Immunodeficiency Virus positive individuals. However, first-line antiretroviral treatment failure becomes a public health issue and early detection of treatment failure is crucial for timely actions. Therefore, this study aims to identify the predictors of time to first-line antiretroviral treatment failure among adult patient living with HIV in public health facilities of Arba Minch town.

Methods: Institution-based retrospective cohort study was employed among 396 adult patients that were selected using simple random sampling. The data on relevant variables were extracted from patient medical cards. The bi-variable and multivariable Cox proportional hazard regression analyses were used to identify predictors.

Findings: The median survival time was 21 months. History of substance use (AHR=2.94, 95% CI=1.62 to 5.32), advanced WHO clinical stage (AHR=2.02, 95% CI=1.02 to 4.00), under nutrition (AHR=3.78, 95% CI=1.99 to 7.17), CD4 count less than 200 cell/mm3(AHR=1.99, 95% CI=1.05 to 3.75), bedridden functional status (AHR=2.71 95% CI=1.33 to 5.51), poor adherence to ART (AHR=1.99, 95% CI=1.05 to 3.76) and time since HIV diagnosis (AHR=2.19 95% CI=1.01 to 4.79) were independent predictors of time to first line ART treatment failure.

Conclusions: History of substance use, lack of disclosure status, time since HIV diagnosis, low CD4 counts, opportunistic infection, bedridden functional status, poor adherence to ART, and under-nutrition affect the time to first-line treatment failure. Therefore, strengthen the early screening and giving nutritional intervention as well as maintain CD4 count in the normal range is very important.