Abstract:
Objective This study aimed to assess the incidence and
risk factors of treatment failure among HIV/AIDS-infected
children who were on antiretroviral therapy (ART) in
Amhara National Regional State, Ethiopia.
Methods A retrospective follow-up study was conducted
from January 2010 to March 2016. A total of 824 children
under the age of 15 who had started ART were included
in the study. Data were collected from children’s medical
charts and ART registration logbook using a standard
checklist. A Weibull regression model was used to identify
the risk factors of treatment failure. Adjusted HRs (AHRs)
with 95% CIs were used to declare statistical significance.
Results The mean (±SD) age of the children was 6.4±3.6
years, with a median (IQR) follow-up of 30.5 (14.6–51.4)
months. Sixty-three children (7.7%, 95% CI 5.8 to 9.5)
developed treatment failure, 17 (27.0%) of whom were
immunological and 46 (73.0%) were clinical failures.
The incidence rate of treatment failure was 22.1/10 000
person-months. The cumulative probability of failure was
0.4, with 28 562.5 person-month observations. Lack of
disclosure (AHR=4. 4, 95% CI 1.8 to 11.3), opportunistic
infections during initiation of ART (AHR=2.3, 95% CI 1.3 to
4.1) and prolonged follow-up (AHR=0.06, 95% CI 0.02 to
0.18) were the main predictors of treatment failure.
Conclusion This study revealed that the incidence of
treatment failure remains a significant public health
concern in Ethiopia. Undisclosed HIV status to children,
the presence of opportunistic infections during initiation of
ART and prolonged follow-up were found to be the main
predictors of treatment failure. Hence, early detection of
treatment failure and further studies on viral monitoring
need to be considered.
