Prevalence of antiretroviral treatment failure and associated factors in HIV infected children on antiretroviral therapy at Gondar University Hospital, retrospective cohort study

As the use of highly active antiretroviral therapy (HAART) increases, the issue of drug resistance and subsequent anti-retroviral treatment (ART) failure appears as a challenge. The study aim to assess prevalence of ART treatment failure and associated factors amongst children on ART at Gondar University Hospital, North WEST Ethiopia, 2014. A retrospective cross-sectional study was conducted on children taking ART at Gondar University Hospital by using a systematic random sampling technique to include 225 under 15 Children on ART who took the drugs for at least six months. Data was collected from the patients’ medical records and analyzed by SPSS version 16.0. Binary logistic regression with multivariate analysis was used. Data from 225 children was analyzed, where the mean age was 10.8 years. The majority of children (77.4%) were in advanced clinical stage before initiation of HAART. About 60% of children were started with regimen of AZT-3TC-NVP. The original first line regimen was substituted in 44.9% of patients. About 101 patients who took ART for a mean of 60.3 months had poor adherence. There were 41 patients (18.2%) who had evidence of first line ART treatment failure of which the most common type is both clinical and immunological. Out of all children with first line ART treatment failure, only 14 patients (34%) were detected and started on second line regimens. ARV prophylaxis for PMTCT (p=0.041), advanced clinical stage 3(p=0.046) and stage 4(p=0.035), base line CD4 less than 200 cells or 10% (p<0.001), tuberculosis co-infection (p=0.045), substitution of original regimen (p=0.001), poor adherence during follow up (p= 0.002) and duration of ART above 60 months (p=0.033) were independent risk factors for ART treatment failure.