Introduction: HIV is still a global problem causing high mortality compared to general population even with the use of HAART. The aim of this study is to determine the outcome of patients who were previously diagnosed to have immunological failure, specifically the rate of treatment failure and deaths among them, and also to assess the potential factors associated with these negative outcomes following switch into second line.
Methods: This was a cross sectional cohort study involving HIV patients who were previously diagnosed to have immunological failure between 2012 to 2017 at BMC in Mwanza Tanzania. A systematic clinical stage, OIs, baseline CD4, FBP, ART Regimen, time and outcome on treatment as dead or alive were collected and analyzed using STATA version 11.
Results: In this study a total number of 274 patients were included for analysis. The mean age of the study population was (39.3±9.8) years with most patients 201 (73.4%) being younger than 45 years and female predominance of 178 (65.7%). More than half of participants 196(71.8%) where found to have WHO stage 3&4 with TB being most common 115 (42%) disease found among the participants on diagnosis. The baseline CD4 below 20 cells/µl was found in 201 of participants which was about 73.4%. Of the study participants 52(19%) died, 66(24.1%) experienced immunological failure while 73(26.6%) of total participants experienced virological failure. The mortality was independently associated with low baseline CD4 ≤200/µl (OR; 2.31, P=0.02) and weight ≤45kg (OR: 3.85. P=0.0007) while virological failure was independently associated with both clinical stage 3&4 (OR: 2.31, P=0.02) and Baseline CD4 ≤200/µl (OR; 2.31, P=0.02)