{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:26:22Z","timestamp":1789539982851,"version":"build-2803163510"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n Second-line HIV treatment failure has become increasing worldwide, mainly in sub-Sahara Africa including Ethiopia. Even though the problem becomes increasing, inadequate information was available about its magnitude and associated factors in the current study area.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the factors of second-line Anti-Retroviral Treatment virological failure among second-line ART users.<\/jats:p>\n <\/jats:sec>\n \n Method and materials<\/jats:title>\n Institutional-based unmatched case-control study design was conducted from September to December 2021 at Felege Hiowt and University of Gondar Comprehensive Specialized Hospitals; Amhara region, Northwest Ethiopia. A total of 216 patients (60 cases and 156 controls) were recruited by a simple random sampling technique with a 1:3 cases-to-controls ratio. Patients who had two viral load results >1000 copies\/ml within a 3-month interval after taking ART drugs for at least 6 months were cases and those who had \u22641,000 copies\/ mL were controls. The sample size was calculated by using Epi-Info version 7.2.4. Structured questionnaires were used to gather the required information. SPSS version 26 was used to summarize the findings. In bivariate logistic regression model, Variables with two-tailed P-value \u2264 0.25 at 95% confidence interval were transferred into multivariate binary logistic regression model and P value at \u2264 0.05 was set as statistically significant.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Out of 216 patients recruited, 212 have participated with a response rate of 98.2%. From these participants, 117(55.2%) were males and 187(88.2%) were urban dwellers. Among the total respondents, 208(98.1%) had age > 24 years, 200(94.3) were at HIV clinical stage I, 72(34%) had poor ART adherence and 112(52.8) did not disclose their HIV status. Likewise, most of the patients 147(69.37) didn\u2019t use condoms. The associated factors were not disclosing HIV status (AOR = 3.4, 95% CI: 1.52\u20137.79), medium adherence (AOR = 3.7, 95% CI = 1.3\u201310.7), poor adherence level (AOR = 5.27, 95% CI: 2.2\u201312.5), not using condoms (AOR = 4.47, 95% CI: 1.63\u201312.2) and Viral load (>150 copies\/ml) when switched to second-line ART (AOR = 3.56, 95% CI: 1.5\u20138).<\/jats:p>\n <\/jats:sec>\n \n Conclusion and recommendations<\/jats:title>\n Non-disclosure, poor or medium adherence, not using condoms and high Viral load (>150 copes\/ml) when switched to second-line ART were the main factors for second-line Anti-Retroviral Treatment virological failure. Disclosure about HIV status, using condoms and improving treatment adherence level are crucial to reduce second-line virological failure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0289450","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T14:27:45Z","timestamp":1720535265000},"page":"e0289450","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Determinants of virological failure among HIV clients on second-line antiretroviral treatment at Felege-hiwot and University of Gondar comprehensive specialized hospitals in the Amhara Region, Northwest Ethiopia: A case-control study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3212-3125","authenticated-orcid":true,"given":"Getahun","family":"Ayenew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeshambel","family":"Agumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tebkew","family":"Shibabaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebremariam","family":"Getaneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7461-859X","authenticated-orcid":true,"given":"Michael","family":"Getie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"pone.0289450.ref001","volume-title":"HIV and 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