Incidence and predictors of treatment failure to second line Antiretroviral treatment in a young people living with HIV clinic

Abstract

Background: Second line (PI) based regimens are still very expensive in most developing nations yet will be needed soon by the high number of people on ART due to treatment failure. We asked whether socio-demographic, laboratory and treatment data can be used to estimate the incidence of treatment failure on second line based regimens and to predict treatment failure in a young people living with HIV clinic at Baylor-Uganda. Methods: A retrospective cohort study was carried out on 298 medical records of young people living with HIV receiving second line care and treatment at Baylor-Uganda between the period 2010 and 2013. Results: During the follow up time of 12 (5-49.0) months, there were 65 (21.8%) primary endpoints (treatment failure). The incidence rate was 18.2 (14.3-23.2) per 100 person years and the predictors that were associated with second line treatment failure were duration on ART medication of 1-2 years (HR=3.485, p=0.009), duration on ART of 3-4 years (HR=4.186, p=0.000), duration on ART of > 5years (HR=7.418, p=0.000), viral load > 1000 cp/ml (HR=3.933, p=0.000) and adherence levels < 95% (HR=2.775, p=0.001). Conclusion: A relatively high rate of treatment failure was reported from a clinical setup among young people living with HIV/AIDS in Kampala Uganda. Elevated viral load count, poor adherence and duration on ART were the predictors identified to second line treatment failure.