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Table 1 Associations of variables with viral non-suppression among HIV infected adolescents and adult patients on ART in Northern Ethiopia. (n = 19,525)

From: HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study

Variable

Category

Viral suppression status

Total n (%)

COR(95% CI)

AOR (95% CI)

Suppressed, n (%)

Non suppressed, n (%)

Gender

Female

9738 (67.76)

3128 (60.70)

12,866 (65.90)

1 (Ref.)

 

Male

4634 (32.24)

2025 (39.30)

6659 (34.10)

1.36 (1.27, 1.45)***

1.27 (1.18, 1.37) ***

Pregnant mother

No

9659 (99.19)

3112 (99.49)

12,771 (99.26)

1 (Ref.)

1 (Ref.)

Yes

79 (0.81)

16 (0.51)

95 (0.74)

0.63 (0.37, 1.08)

 

Lactating mother

No

9577 (98.35)

3087 (98.69)

12,664 (98.43)

1 (Ref.)

 

Yes

161 (1.65)

41 (1.31)

202 (1.57)

0.79 (0.56, 1.12)

 

Age category

15–19

204 (1.42)

216 (4.19)

420 (2.15)

3.67 (2.97, 4.53) ***

4.86 (3.86, 6.12) ***

20–24

391 (2.72)

164 (3.18)

555 (2.84)

1.45 (1.19, 1.78) ***

1.96 (1.57, 2.45) ***

25–29

1312 (9.13)

520 (10.09)

1832 (9.38)

1.37 (1.20, 1.57) ***

1.79 (1.55, 2.08) ***

30–34

2757 (19.18)

959 (18.61)

3716 (19.03)

1.21 (1.08, 1.35) ***

1.46 (1.29, 1.65) ***

35–39

3113 (21.6)

1117 (21.68)

4230 (21.66)

1.24 (1.11, 1.39) ***

1.43 (1.27, 1.61) ***

40–44

2749 (19.13)

964 (18.71)

3713 (19.02)

1.21 (1.08, 1.36) ***

1.22 (1.08, 1.39) ***

45–49

1587 (11.04)

561 (10.89)

2148 (11.00)

1.22 (1.08, 1.39) **

1.22 (1.06, 1.40) **

50+

2259 (15.72)

652 (12.6)

2911 (14.91)

1 (Ref.)

1 (Ref.)

Age

Median (IQR)

38 (32–45)

37 (30–44)

38 (31–45)

  

Facility ownership

Government

13,713 (95.41)

4958 (96.22)

18,671 (95.63)

1.20 (1.02, 1.41) *

1.09 (0.89, 1.33)

Non-governmental organization

645 (4.49)

195 (3.78)

840 (4.30)

1 (Ref.)

 

Private

14 (0.10)

0

14 (0.07)

___

 

Facility type

Clinic

30 (0.21)

13 (0.25)

43 (0.22)

1.35 (0.69, 2.61)

 

Health center

4191 (29.16)

1491 (28.93)

5682 (29.10)

1.11 (0.97,1.26)

 

Primary Hospital

1428 (9.94)

703 (13.64)

2131 (10.91)

1.53 (1.32, 1.77) ***

1.26 (1.05, 1.52) *

General Hospital

7315 (50.90)

2514 (48.79)

9829 (50.34)

1.07 (0.94, 1.21)

 

Referral Hospital

1134 (7.89)

365 (7.08)

1499 (7.68)

1 (Ref.)

 

Other

274 (1.91)

67 (1.30)

341 (1.75)

0.76 (0.57, 1.02)

 

Service provided at military health care facility

No

13,837 (96.28)

5013 (97.28)

18,850 (96.54)

1.38 (1.15, 1.67) ***

1.47 (1.15, 1.89) **

Yes

535 (3.72)

140 (2.72)

675 (3.46)

1 (Ref.)

1 (Ref.)

WHO Staging

I

13,255 (92.23)

4574 (88.76)

17,829 (91.31)

1 (Ref.)

1 (Ref.)

II

481 (3.35)

294 (5.71)

775 (3.97)

1.77 (1.53, 2.06) ***

1.31 (1.10, 1.54) **

III

248 (1.73)

160 (3.10)

408 (2.09)

1.87 (1.53, 2.29) ***

1.12 (0.89, 1.40)

IV

388 (2.70)

125 (2.43)

513 (2.63)

0.93 (0.76, 1.15)

 

Adherence

Poor

123 (0.86)

163 (3.16)

286 (1.46)

3.92 (3.09, 4.96) ***

2.56 (1.97, 3.33) ***

Fair

413 (2.87)

309 (6.00)

722 (3.70)

2.21 (1.90, 2.57) ***

1.61 (1.36, 1.90) **

Good

13,836 (96.27)

4681 (90.84)

18,517 (94.84)

1 (Ref.)

1 (Ref.)

Virological test reason

Routine First VL

8910 (62)

3049 (51.17)

11,959 (61.25)

1.41 (1.31, 1.52) ***

1.35 (1.25, 1.46) ***

Routine annual VL Test

4856 (33.79)

1176 (22.82)

6032 (30.89)

1 (Ref.)

1 (Ref.)

Suspected ART failure-Clinical

22 (0.15)

28 (0.54)

50 (0.26)

5.26 (3.00, 9.22) ***

3.37 (1.86, 6.12) **

Suspected ART failure-immunological

38 (0.26)

43 (0.83)

81 (0.41)

4.67 (3.01, 7.26) ***

2.19 (1.36, 3.51) ***

Suspected ART Failure initial VL

301 (2.09)

790 (15.33)

1091 (5.59)

10.84 (9.35, 12.56) ***

7.62 (6.53, 8.90) ***

Not indicated in the form

245 (1.70)

67 (1.30)

312 (1.60)

1.13 (0.86, 1.49)

 

CD4 baseline

< 200 cells/micro liter

6950 (48.36)

2737 (53.11)

9687 (49.61)

1.50 (1.34, 1.68) ***

1.33 (1.14, 1.54) ***

200–499 cell/ micro liter

5653 (39.33)

1952 (37.88)

7605 (38.95)

1.32 (1.17, 1.48) ***

1.32 (1.15, 1.50) ***

+ 500 cells/ micro liter

1769 (12.31)

464 (9.01)

2233 (11.44)

1 (Ref.)

1 (Ref.)

CD4 baseline

Median (IQR)

206 (116–348)

188 (103–320)

201 (112–341)

  

CD4 Recent

< 200 cells/micro liter

1542 (10.73)

1501 (29.13)

3043 (15.59)

5.25 (4.78, 5.77) ***

3.78 (3.34, 4.27) ***

200–499 cell/ micro liter

6441 (44.82)

2468 (47.89)

8909 (45.63)

2.07 (1.91, 2.23) ***

1.89 (1.73, 2.06) ***

+ 500 cells/ micro liter

6389 (44.45)

1184 (22.98)

7573 (38.79)

1 (Ref.)

1 (Ref.)

CD4 Recent

Median (IQR)

463 (307–648)

309 (180–480)

423 (264–611)

  

Regimen

1c (AZT-3TC-NVP)

4147 (28.85)

1685 (32.70)

5832 (29.87)

1.30 (1.21, 1.40) ***

1.32 (1.22, 1.44) ***

 

1d (AZT-3TC-EFV)

1362 (9.48)

545 (10.58)

1907 (9.77)

1.28 (1.15, 1.43) ***

1.31 (1.16, 1.48) ***

1e (TDF-3TC-EFV)

7155 (49.78)

2235 (43.37)

9390 (48.09)

1 (Ref.)

1 (Ref.)

1f(TDF-3TC-NVP)

1559 (10.85)

583 (11.31)

2142 (10.97)

1.20 (1.08, 1.33) ***

1.30 (1.16, 1.46) ***

1 g (ABC-3TC-EFV)

5 (0.035)

1 (0.019)

6 (0.03)

0.64 (0.07, 5.48)

 

1 h(ABC-3TC-NVP)

4 (0.028)

3 (0.058)

7 (0.04)

2.40 (0.54, 10.74)

 

2a (ABC-ddl-LPV/R), 2c (TDF-ddl-LPV/R), 2d(TDF-ddl-NFV)& 2 g (TDF-3TC-LPV/r)

8 (0.056)

4 (0.078)

12 (0.06)

1.60 (0.48, 5.32)

 

2f (AZT-3TC-ATV/r)

39 (0.27)

23 (0.446)

62 (0.32)

1.89 (1.13, 3.17) *

1.65 (0.95, 2.86)

2 h (TDF-3TC-ATV/R)

93 (0.65)

74 (1.436)

167 (0.86)

2.55 (1.87, 3.47) ***

1.79 (1.27, 2.52) ***

Treatment

First line

14,232 (99.03)

5052 (98.04)

19,284 (98.77)

1 (Ref.)

1 (Ref.)

Second line

140 (0.97)

101 (1.96)

241 (1.23)

2.03 (1.57, 2.63) ***

Omitted

Immunological response after ART initiation

Declined

2133 (14.84)

1406 (27.29)

3539 (18.13)

2.16 (2.00, 2.33) ***

1.45 (1.30, 1.61) ***

No change

183 (1.27)

67 (1.30)

250 (1.28)

1.20 (0.90, 1.59)

0.86 (0.64, 1.17)

Enhanced

12,056 (83.89)

3680 (71.41)

15,736 (80.59)

1 (Ref.)

1 (Ref.)

  1. Notes: *significant at P-value of ≤0.05; ** significant at P-value of ≤0.01; significant at P-value of ≤0.001; Omitted, Collinearity effect was allowed to be omitted in the multivariable analysis
  2. Abbreviations: 3TC lamivudine; ABC abacavir; AOR Adjusted Odds Ratio; ATV/r atazanavir/ Ritonavir; AZT azidothymidine; CD-4 Cluster of Differentiation 4; COR Crude Odds Ratio; ddl didanosine; EFV efavirenz; LPV/R Lopinavir/Ritonavir; n number; NFV nelfinavir; NVP nevirapine; P-value, Precession value; Ref Referrence; TDF tenofovirdisoproxilfumarate