Determinants of Virologic Failure Among Adult Hiv Patients on First Line Atiretroviral Treatment at Oromia, Central Ethiopia: 2022 a Case –control Study

Abstract Background: The problem of viral failure among first line antiretroviral treatment is growing in Ethiopia despite the 3rd 95’s target of 2025.Ethiopia's viral suppression rate was less than 90% by 2020 and more than 10% of adult client on ART in Woliso Town were unsuppressed at the end of March 2022. This study aims to identify determinants of virologic failure among adult clients on first line ART at Health facilities in Oromia region, Ethiopia Methods: Facility based unmatched case-control study was conducted at health facilities at Oromia region, Ethiopia from August 1 to September 01, 2022. A total of 135 cases and 268 controls participants were selected using simple random sampling technique and data were collected by review of client’s document. Epi-info7was used for data entry and SPSS version 20 for data analysis. Variables having a P-value of less than 0.25 in bi-variable analysis were included in multivariable logistic regression. Determinants of virologic failure were determined based on adjusted odds ratio using 95 % CI and at a P-value of <0.05. Result: In this study, clients with age ≥ 35 years (AOR =3.4, 95% CI: 1.6, 7.0), clients with a baseline regimen of AZT+3TC+NVP (AOR=3.5, 95% CI:1.4,8.8), clients with base-line CD4 count <350 mm3 (AOR=2.3,95%CI:1.1,4.5),clients who had history of appointment spacing model (AOR=0.05,95%CI:0.03,0.10), being single marital status(AOR=3.7,95% CI:1.4,10.5),TB-HIV coinfection(AOR=2.58, 95% CI:1.3,5.1) and having opportunistic infection in last six months (AOR=3.06,95%CI: 1.5,6.3) were factors significantly associated with virologic failure. Conclusion: This study showed that age ≥ 35 years, being single, baseline ART regimen with (AZT+3TC+NVP), Baseline CD4 cell count <350 mm3, Tb-co infection, opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement to appointment spacing model was found to be protective for.