Abstract:

Background: HIV causes immune suppression through attack of CD4 positive cells reducing its number and quality most morbidity and mortality from opportunistic infections (1). Antiretroviral therapy (ART) induces a durable suppression of HIV replication and restoration of the body’s ability to fight against OI (2) and as such its use has dramatically improved the outcome of PLWHA (3, 4).

Methods: A retrospective clinic based cohort study involving adult HIV patients diagnosed to have immunological failure at Sengerema care and treatment center (CTC) was conducted. Data entry was computerized using Epi data version 3.1 and STATA version 11 (STATA Corp LP, college station, TX) was used for data analysis. Virological failure was defined as >1000 copies/ml. In all our analysis factors were said to be statistically significant when the p value is less than 0.05.

Results: A total of 132 patients were included in this study. Most patients were female 78 (59.09%) with a female to male ratio of 1.4:1. The median age of study participants was 45 [36-53.5] years and mortality 76 [57.58%] started ART with severe immune suppression. On the 132 patients who had a diagnosis of treatment failure immunologically 104 (78.8%) were virologically suppressed and only 28 (21.2%) had a conformed treatment failure. The odds of having an associated virological non response was independently associated with young age than 50 years (AOR=2.6, p=0.037) and higher baseline CD4 counts than 200 cells/µl (AOR=2.4, p=0.05).

Conclusion: This study revealed that the virological non response is as high as 78.8%. And it also showed the virological failure is affected by age (high in >50 years) and the baseline CD4 count less than 200 cells/µl.