A cross-sectional study to evaluate second line virological failure and elevated bilirubin as a surrogate for adherence to atazanavir/ritonavir in two urban HIV clinics in Lilongwe, Malawi

Table 4 Factors associated with second line virological failure in two urban HIV clinics in Lilongwe, Malawi

	Un-adjusted		Adjusted
Characteristics	Odds Ratios	p-value	Odds Ratios	p-value
Age in years (at time of study evaluation)
> 40	Referent
25–40	3	0.008	2.5	0.048
15–24	4.5	0.012	1.5	0.611
age, per each additional year	0.9	0.003
age at second line ART initiation, per additional year	<1.0	0.008
Gender
female	Referent
male	<1.0	0.936	1.2	0.698
Total time on ART, per additional month	<1.0	0.794
Time on second line ART, per additional month	<1.0	0.154	1	0.921
Time on ATV/r, per additional month	<1.0	0.706	0.9	0.409
BMI (kg/m²)
normal	Referent
underweight	1.5	0.525	0.4	0.235
overweight/obese	0.4	0.034	0.3	0.026
Current boosted protease inhibitor
ATV/r	Referent
LPV/r	3.3	0.305
Current NRTI backbone
TDF/3TC	Referent
AZT/3TC	<1.0	0.942
ABC/3TC	2.5	0.429
d4T/3TC	1
CD4 cell count (cells/mm³)
≥ 100	Referent
< 100	17.4	<0.001	17.5	<0.001
Pill count adherence
good (95% - 105%)	Referent
poor (<95% or >105%)	0.9	0.804	0.7	0.4
Total bilirubin, per unit rise (mg/dL)	0.3	<0.001
Total bilirubin level
elevated (>1.3 mg/dL)	Referent
normal (≤1.3 mg/dL)	4.9	<0.001	5.4	<0.001

Variables included in the multivariate analysis that are not known predictors of second line ART failure had p-values <0.05 in the univariate analysis. Multicollinearity was assessed using variance inflation factors

ISSN: 1471-2334