Factors determinant for change of initial antiretroviral treatment regimen among patients on ART follow-up clinic of Mekelle Hospital, Mekelle, Ethiopia
Keywords:Antiretroviral therapy, Case-control, ART follow up, Determinant factors, ART regimen change
Background: Treatment interruption and switch to a new Highly Active Antiretroviral Therapy (HAART) regimen act as competing risks for patient on HAART.
Methods: The study was conducted in Mekelle hospital. A case-control study was conducted. Socio-demographic, immunologic and clinical characteristics were components of the checklist. Data was compiled, processed, and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 16. Ethical consideration was obtained from Mekelle University.
Results: 105 patients’ records were sampled and studied. Twenty one (20%) of the patients had changed their initial ART regimen and about three-fourth 15 (71.4%) of the reasons for change was attributable to toxicity while 3 and 2 were due to treatment failure and pregnancy respectively. The odds of Adverse Drug Reactions (ADRs) who had one initial ART change (cases) were 2.37 times greater than the odds who did not change (controls) Patients, initiated ZDV based ART regimen had 9.93 times greater chance of changing their initial ART regimen compared to those initiated with D4T based ART regimen and patient on ART for treatment duration of 12-36 months were relatively at higher risk compared to patients with lesser duration of treatment. Patients who’s ART had 99.94% lesser chance of changing their baseline ART regimen compared to those who did take other medications
Conclusions: The main factor determining the change of initial ART regimen in our study was the occurrence of adverse drug reactions, with ZDV being the most dominant drug.
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