Clinical outcomes and retention among HIV infected adolescents and adults initiated on protease inhibitors antiretroviral therapy regimen in Dar es salaam; A Longitudinal retrospective descriptive study.

Sariah, Adellah

Clinical outcomes and retention among HIV infected adolescents and adults initiated on protease inhibitors antiretroviral therapy regimen in Dar es salaam; A Longitudinal retrospective descriptive study.

dc.contributor.author	Sariah, Adellah
dc.date.accessioned	2021-10-27T10:54:02Z
dc.date.available	2021-10-27T10:54:02Z
dc.date.issued	2021-01-06
dc.description.abstract	Background: Globally antiretroviral therapy access has increased and significantly changed HIV morbidity and mortality patterns. In sub-Saharan Africa there are reports of increasing rates of failure to second-line antiretroviral treatment (ART) hence, assessment for clinical outcomes is critical. Objectives: To assess clinical outcomes and retention using programmatic indicators among HIV-infected adolescents and adults receiving second-line ART in Tanzania. Methods: In this longitudinal retrospective cohort study, we enrolled HIV-infected individuals aged 15 years and above who were initiated on second-line ART (Protease Inhibitor based regimen) due to documented failure of first-line ART between July 2012 and September 2015. We evaluated mean change in CD4 cell count, HIV viral load and retention using survival analysis. Results : A total of 1446 participants were enrolled, the mean duration of second-line therapy was 37.0 months± SD 26.50 and the median CD4 cell count at initiation of the second line was 290 cells/mm3. Virologic suppression <50 copies/ml was increasing over time and reached 58% at 36 months. Six months after switching, 80% of patients were retained and thereafter. Predictors of retention were male gender with hazard ratio (HR) 1.04; 95% CI 1.0-1.1 P-value 0.037 and younger age (25 -39 years) with HR 1.1; 95% CI 1.0-1.2 P-value 0.006. Additionally, adherence > 90% increased the likelihood of retention with a strong correlation HR 1.4; 95% CI 1.1-1.7 P-value 0.00. Clinical stage III and IV at switch were less likely to be retained HR 0.6; 95% CI 0.5-0.6 P-value 0.000 and higher CD4 cell count was associated with less retention HR <1; 95 % CI 0.4-0.6 P-value 0.000. Conclusion: There was a low rate of viral suppression (<50copies/ml) 58% 36 months after switch however, more than 87% of participants were retained to care after switch. Predictors of retention were male gender, younger age (25-39 years) and adherence > 90%. Therefore, improving viral suppression after switching to second-line requires further interventions.	en_US
dc.identifier.citation	Rugemalila, J., Sariah, A., Mwaikambo, S., Sando, D. and Kalluvya, S., 2021. Clinical Outcomes and Retention Among HIV-Infected Adolescents and Adults Initiated on Protease Inhibitors Antiretroviral Therapy Regimen in Dar ES Salaam; A Longitudinal Retrospective Descriptive Study.	en_US
dc.identifier.other	https://assets.researchsquare.com/files/rs-141017/v1/82564b4b-6715-4ae9-b7f9-2dd3d003d624.pdf?c=1631870012
dc.identifier.uri	http://hdl.handle.net/123456789/810
dc.language.iso	en	en_US
dc.publisher	Research Squaire	en_US
dc.subject	Protease inhibitors outcomes	en_US
dc.subject	Predictors of retention	en_US
dc.subject	Predictors of viral suppression	en_US
dc.title	Clinical outcomes and retention among HIV infected adolescents and adults initiated on protease inhibitors antiretroviral therapy regimen in Dar es salaam; A Longitudinal retrospective descriptive study.	en_US
dc.type	Article	en_US