{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:27:24Z","timestamp":1789540044956,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The study aimed to identify the predictive factors associated with virological failure among adult patients living with HIV on first-line highly active antiretroviral therapy (HAART) in selected hospitals in Southeast Oromia, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A facility-based unmatched case\u2013control study was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in three selected hospitals in Southeast Oromia, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study included a final sample size of 282 participants, comprising 94 cases and 188 controls. A simple random sampling technique was employed to select participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measurement<\/jats:title>\n                    <jats:p>The main outcome of this study was virological failure among adult patients living with HIV on first-line HAART. Virological failure was defined as a binary outcome: a case indicated the presence of failure, defined as adults aged\u226515 years with a viral load (VL)&gt;1000 copies\/mm\u00b3 in two consecutive measurements taken 3 months apart, following enhanced adherence counselling (EAC) after 6 months of treatment. A control indicated the absence of failure, defined as patients aged\u226515 years with a VL&lt;1000 copies\/mm\u00b3 in two consecutive measurements after at least 6 months of treatment. The study used routine viral load testing records, recommended at 6 and 12 months and annually thereafter, with the WHO threshold of 1000 copies\/mL used to define virological failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individuals under the age of 35 had higher odds of virological failure (adjusted OR (AOR): 2.0; 95%\u2009CI (1.1 to 3.6)) compared with those older than 35. People with a body mass index (BMI) below 18.5 had higher odds of virological failure (AOR: 2.4; 95%\u2009CI (1.0 to 5.7)). Those with poor adherence had significantly higher odds of virological failure (AOR: 5.1; 95%\u2009CI (2.7 to 9.9)). Individuals attending less than 50% of their scheduled visits had increased odds of virological failure (AOR: 3.2; 95%\u2009CI (1.3 to 8.0)). Those with a history of co-trimoxazole preventive therapy use had higher odds of virological failure (AOR: 4.1; 95%\u2009CI (1.4 to 11.9)). Individuals with a baseline CD4 (cluster of differentiation) count below 200\u2009cells\/mm\u00b3 had higher odds of virological failure (AOR: 3.6; 95%\u2009CI (2.0 to 6.7)) compared with those with higher counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study has identified several key factors, including education level, marital status, duration of HAART, younger age, current BMI, adherence to treatment, scheduled healthcare visits, history of co-trimoxazole preventive therapy use and baseline CD4 count, as significant determinants of virological failure within the studied population. The study\u2019s identification of determinants of virological failure among people living with HIV is crucial for decreasing the prevalence of virological failure and improving the health of people living with HIV. Therefore, targeted counselling and support can play a crucial role in enhancing patient understanding, motivation and engagement with their treatment, ultimately contributing to improved virological suppression and overall health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093797","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T23:55:23Z","timestamp":1744934123000},"page":"e093797","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Predictive factors associated with virological failure among adult patients living with HIV on first-line highly active antiretroviral therapy in Southeast Oromia, Ethiopia: a case\u2013control study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-8557","authenticated-orcid":false,"given":"Lalisa Kebebe","family":"Gedefa","sequence":"first","affiliation":[{"name":"Department of Public Health Emergency Management at Oromia Health Bureau, UNICEF Ethiopia, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1795-7867","authenticated-orcid":false,"given":"Assefa Washo","family":"Bankere","sequence":"additional","affiliation":[{"name":"Department of Public Health, Hawassa College of Health Science, Hawassa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deriba","family":"Bedane","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitesa Biresa","family":"Duftu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0180-9669","authenticated-orcid":false,"given":"Buzuneh Tasfa","family":"Marine","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"2025121222500588000_15.4.e093797.1","doi-asserted-by":"crossref","unstructured":"Desalegn M , Seyoum D , Tola EK , et al . 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