{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:26:24Z","timestamp":1789539984588,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the increasing number of patients on second-line antiretroviral therapy in low-income countries such as Ethiopia, there is limited evidence regarding the time to viral re-suppression. Therefore, this study aimed to assess the time to viral load re-suppression and its predictors among adult patients on second-line antiretroviral therapy in northeastern Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A multi-center, institution-based prospective follow-up study was conducted over 48\u202fmonths, from February 2022 to February 2024, involving 526 adults living with human immunodeficiency virus (HIV) who were receiving second-line antiretroviral therapy in northeastern Ethiopia. Data were collected through face-to-face interviews and chart reviews. A Weibull proportional hazards model was fitted to identify the predictors of viral re-suppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median time to viral re-suppression was 9\u202fmonths (IQR\u202f=\u202f3\u201315\u202fmonths). The rate of viral re-suppression was 44.3 per 1,000 person-months (95% CI: 40.4\u201349). Predictors of viral re-suppression included disclosure of Human Immunodeficiency Virus (HIV) status [AHR 2.24 (95% CI: 1.4\u20133.7)], classification in World Health Organization (WHO) clinical stages I and II [AHR 6.9 (95% CI: 4.4\u20139.6)], receipt of tuberculosis (TB) preventive treatment [AHR 3.7 (95% CI: 2.3\u20135.93)], absence of first-line drug substitution history [AHR 1.44 (95% CI: 1.2\u20131.8)], and good adherence to treatment [AHR 1.9 (95% CI: 1.4\u20132.54)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and recommendations<\/jats:title><jats:p>In this study, the time to viral load re-suppression was longer than expected. Disclosure status, WHO clinical stage I or II, receiving tuberculosis preventive treatment, and the absence of first-line drug substitution history were predictors of viral load re-suppression. Health managers and antiretroviral therapy care providers must improve the timing and effectiveness of early disclosure, encourage the early use of tuberculosis prophylaxis, and maintain good adherence through various strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1496144","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T05:14:57Z","timestamp":1741583697000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Time to viral load re-suppression and its predictors among adult patients on second-line anti-retro viral therapy in northeastern Ethiopia: multi-center prospective follow-up study"],"prefix":"10.3389","volume":"12","author":[{"given":"Abebe Yehualaw","family":"Melaku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niguss","family":"Cherie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarikua Afework","family":"Birhanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluken Amare","family":"Wudu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"ref1","volume-title":"Monitoring health for the SDGs, Sustainable Development Goals","year":"2024"},{"key":"ref2","volume-title":"The path that ends AIDS: UNAIDS Global AIDS update 2023","year":"2023"},{"key":"ref3","volume-title":"The global health observatory [online database]","year":"2023"},{"key":"ref4","year":"2016"},{"key":"ref5","first-page":"12","article-title":"Evidence of HIV treatment and viral suppression in preventing the sexual transmission of HIV","volume":"4","year":"2018","journal-title":"Dep Heal Hum Serv"},{"key":"ref6","first-page":"e0220159","article-title":"Second-line HIV treatment failure in sub-Saharan Africa: A systematic review and meta-analysis","volume-title":"PLoS One","author":"Edessa","year":"2019"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S68","DOI":"10.1038\/nature16046","article-title":"Sustainable HIV treatment in Africa through viral-load-informed differentiated care","volume":"528","author":"Phillips","year":"2015","journal-title":"Nature"},{"key":"ref8","first-page":"1","article-title":"Pocket guide. 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