{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:53:10Z","timestamp":1787921590706,"version":"build-2784847793"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Information on treatment failure (TF) in People living with HIV in a data-poor setting is necessary to counter the epidemic of TF with first-line combined antiretroviral therapies (cART) in sub-Saharan Africa (SSA). In this study, we examined the risk factors associated with TF in Asmara, Eritrea from 2001 to 2020.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A multicenter, retrospective 1:2 matched (by age and gender) case\u2013control study was conducted in four major hospitals in Asmara, Eritrea on adults aged\u2009\u2265\u200918\u00a0years who were on treatment for at least 6\u00a0months. Cases were patients who fulfills at least one of the WHO therapy failure criterion during the study period. Controls were randomly selected patients on first-line treatment and plasma viral load\u2009&lt;\u20091000 copies\/ml in their latest follow-up measurement. Multivariable logistic regression analysis was conducted to identify risk factors for TF. All <jats:italic>P<\/jats:italic>-values were 2-sided and the level of significance was set at P\u2009&lt;\u20090.05 for all analyses.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 1068 participants (356 cases; 712 controls), 585 (54.7%) were females. The median age at treatment initiation was 46\u00a0years [interquartile range (IQR): 39\u201351]. Median time to combined antiretroviral therapy (cART) failure was 37\u00a0months (IQR\u2009=\u200924\u201347). In the\u00a0multivariate analysis, factors associated with increased likelihood of TF included initial\u00a0nucleoside reverse transcriptase inhibitors (NRTI) backbone\u00a0(Zidovudine\u2009+\u2009Lamivudine (AZT\u2009+\u20093TC): adjusted odds ratio (aOR)\u2009=\u20092.70, 95% Confidence interval (CI): 1.65\u20134.41, P-value\u2009&lt;\u20090.001), (Abacavir\u2009+\u2009lamivudine (ABC\u2009+\u20093TC): aOR\u2009=\u20094.73, 95%CI: 1.18\u201318.92, P-value\u2009=\u20090.028], and (Stavudine\u2009+\u2009Lamivudine (D4T\u2009+\u20093TC): aOR\u2009=\u20095.00; 95% CI: 3.03\u20138.20, P-value\u2009&lt;\u20090.001) in comparison to Emtricitabine and Tenofovir diproxil fumarate (FTC\u2009+\u2009TDF). Additional associations included prior exposure to cART (aOR\u2009=\u20092.28, 95%CI: 1.35\u20133.86; P-\u2009value\u2009=\u20090.002), record of sub-optimal drug adherence (aOR\u2009=\u20093.08, 95%CI: 2.22\u20134.28; P\u2009&lt;\u20090.001), ambulatory\/bedridden at presentation (aOR\u2009=\u20091.61, 95%CI: 1.12\u20134.28; P-value\u2009=\u20090.010), presence of comorbidities (aOR\u2009=\u20092.37; 95%CI: 1.36\u20134.10, P-value\u2009=\u20090.002), duration of cART (&lt;\u20095\u00a0years: aOR: 5.90; 95% CI: 3.95\u20138.73, P-value\u2009&lt;\u20090.001), and use of SMX-TMP prophylaxis (aOR\u2009=\u20092.00, 95%CI, 1.44\u20132.78, P-value\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our findings underscore the importance of optimizing cART adherence, diversification of cART regimens, and interventions directed at enhancing early HIV diagnosis, prompt initiations of treatment, and improved patient-focused monitoring of treatment response.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07797-2","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T20:06:19Z","timestamp":1668110779000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Determinants of therapy failure among adults on first-line antiretroviral therapy in Asmara, Eritrea: a multicenter retrospective matched case\u2013control study"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2817-1421","authenticated-orcid":false,"given":"Samuel Tekle","family":"Mengistu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0275-2279","authenticated-orcid":false,"given":"Ghirmay Ghebrekidan","family":"Ghebremeskel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-3366","authenticated-orcid":false,"given":"Hermon Berhe","family":"Ghebrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8013-0785","authenticated-orcid":false,"given":"Oliver Okoth","family":"Achila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-3015","authenticated-orcid":false,"given":"Nahom Asmerom","family":"Yohannes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amon Solomon","family":"Ghebrenegus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filmon Ghebretsadik","family":"Wendmhuney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naod","family":"Yeibyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3045-3153","authenticated-orcid":false,"given":"Amanuel Kidane","family":"Andegiorgish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0815-2917","authenticated-orcid":false,"given":"Araia Berhane","family":"Mesfin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0164-8530","authenticated-orcid":false,"given":"Negassi","family":"Leake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"7797_CR1","unstructured":"UNAIDS. 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Information on the maintenance of data confidentiality and integrity was also provided. The need for informed consent was waived by the ethics committee\/Institutional Review Board of [Eritrean Ministry of Health (MOH) Research Ethical Committee], because of the retrospective nature of the study. This study conforms to the principles outlined in the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflict of interest to declare in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"834"}}