எய்ட்ஸ் & மருத்துவ ஆராய்ச்சி இதழ்

Background: Antiretroviral treatment (ART) scale-up has resulted in significant reductions in HIV-related morbidity and death. However, attrition from ART care remains a major public health concern, and it has been highlighted as one of the most important reportable factors in evaluating the success of ART programs. However, there are few researches in the subject region that indicate the incidence and predictors of it. As a result, the goal of this study was to determine the rate of attrition and predictors of attrition among adult HIV patients who started antiretroviral therapy (ART) at Dessie Referral Hospital.

Method: An Institution-based retrospective follow up study was conducted from January 2015 to October 2019. A sample of 565 patients was selected using simple random sampling and we were use data extraction checklist for extracting data from patient charts. The proportional hazard assumption was verified visually and using the Schoenfeld residual global test; a bi-variable cox regression analysis was performed. In the bivariable study, variables having a p-value of 0.2 were fitted to the multivariable cox regression analysis.

Result: A total of 565 adult HIV patients on ART were included in the analysis, The Incidence rate of over all attrition in this study was 14.2 per 100 person-year (95% CI; 12.2-16.6). Having ambulatory functional status, (aHR=2.08; 95% CI (1.29-3.33)), a patient who did not disclosed their HIV status (aHR=2.27; 95%CI; 1.39-3.69), presence of Comorbidity throughout the follow-up time 2.11 (aHR-2.11;95%CI (1.38-3.23)), patients who didn’t take CPT prophylaxis 1.68 (aHR-1.68;95%CI (1.34-2.49)),fair and poor level of adherence 2.75 (aHR=2.75; 95%CI (1.75-4.30)) and 2.16 (aHR=2.16; 95%CI (1.39-3.36)) respectively were significant predictors of attrition.

Conclusion: In this study, the incidence of attrition was high. Patients on ART who did not disclose their HIV status, those who were in fair and poor level of adherence, those did not take CPT prophylaxis,, ambulatory functional status, patients who had co morbidity at enrollment, were at higher risk of Attrition. Therefore, intensive monitoring, reminders, surveillance, and tracking mechanisms aimed at this higher-risk population would reduce ART attrition.

For patients failing a dolutegravir (DTG)-based regimen, understanding a patient's personal history of antiretroviral (ARV) exposure will become increasingly important. With the universal initiation and switch to DTG-based regimens for currently stable patients, the terminology of first-, second- and third-line antiretroviral therapy (ART) is no longer applicable. The adoption of a patient centric approach will ensure that patients receive the most appropriate regimen to achieve virologic suppression. This article proposes a few recommendations for adopting a patient-centric approach to HIV treatment.

Introduction: Human immunodeficiency virus positive children are highly vulnerable for stunting and stunting is the most serious public health problems in human immunodeficiency virus-positive children who received antiretroviral therapy in the developing world particularly low and middle-income countries. Therefore, the aim of the study was to assess the magnitude of stunting and its associated factors among human immunodeficiency positive children in public Hospitals Northwest, Ethiopia.

Methods: Multicenter cross-sectional study was conducted among 372 HIV infected children. Data were collected systematically from selected participants by using interviewer administered structured and pre-tested questionnaires. We used Epi-data version 4.1 for data entery, and STATA Version 14.1 for data analysis. a p-value of <0.05 was considered to declare statistical significance with the corresponding 95% confidence interval. The goodness of fit (GOF) of the model was checked using Hosmer-Lemeshow GOF test. The p-value of the Hosmer-Lemeshow GOF test of this model is p-value greater than 0.05 which confirms that the model is correctly specified.

Results: The magnitude of stunting was found to be 45.2%, 95% CI (40.4-50.0). Being males (AOR:1.942, 95% CI:1.188, 3.175), age of the child 2-5 years old, opportunistic infections (AOR: 2.40,95%,CI: 1.61, 7.60), and fair/poor dietary diversity (AOR:1.832,95% CI:1.1280, 2.95) were found statically significant associated factors.

Conclusion: More than one-thrid of chlidern was stunted among human immunodeficiency virus-positive children received antiretroviral therapy. Therefore, early detection and treatment of opportunistic infections, control progression of HIV, educating and counseling the use of a diversified diet,and monitoring this situation was highly recommended.