Table 2.
Factors associated with HIV-1 drug resistance in Ethiopian children experiencing virologic failure of first-line cART.
| Variable 1 | NRTI Resistance | NNRTI Resistance | Any Resistance | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Yes (N = 64) | No (N = 26) | p | Yes (N = 72) | No (N = 18) | p | Yes (N = 73) | No (N = 17) | p | ||
| Age at baseline, years, Median (IQR), [N = 90] | 11 (8.0–14.0) | 12.8 (11.0–14.0) | 0.07 | 12.0 (9.0–14.0) | 12.0 (9.0–13.0) | 0.73 | 12.0 (9.0–14.0) | 12.0 (10.0–13.0) | 0.51 | |
| Sex, % Male, [N = 90] | 66% | 54% | 0.34 | 60% | 72% | 0.42 | 60% | 71% | 0.58 | |
| ART duration at baseline, months Median [IQR], [N = 86] | 49.5 (23.0–71.8) | 25.5 (7.3–61.5) | 0.11 | 48.5 (23.0–72.0) | 20.5 (4.8–51.8) | 0.03 | 48.0 (22.5–72.0) | 24.0 (6.9–54.5) | 0.08 | |
| WHO Clinical Stage at baseline, % Stage 1, [N = 90] | 86% | 81% | 0.54 | 86% | 79% | 0.48 | 85% | 82% | 0.72 | |
| CD4 count at baseline, cells/mm3 Median [IQR], [N = 88] | 481 (224–752) | 483 (270–781) | 0.79 | 481 (248–674) | 584 (270–910) | 0.50 | 482 (250–700) | 485 (257–957) | 0.66 | |
| CD4 count at ART initiation cells/mm3, Median[IQR], [N = 84] | 280 (136–646) | 265 (195–482) | 0.71 | 245 (149–643) | 292 (200–731) | 0.44 | 261 (151–628) | 270 (198–581) | 0.67 | |
| Baseline Weight-for-age Z-score * Median[IQR], [N = 89] | −1.5 (−2.1–(−0.6)) | −1.7 (−2.2–(−0.9)) | 0.59 | −1.5 (−2.1–(−0.7)) | −1.8 (−2.4–(−1.2)) | 0.2 | −1.5 (−2.1–(−0.6)) | −1.8 (−2.6–(−1.1)) | 0.31 | |
| Baseline Height-for-age Z-score * Median[IQR], [N = 89] | −1.3 (−2.0–(−0.3)) | −1.6 (−2.3–(−0.6)) | 0.32 | −1.3 (−2.1–(−0.4)) | −1.5 (−2.1–(−0.6)) | 0.63 | −1.3 (−2.1–(−0.4)) | −1.4 (−2.1–(−0.6)) | 0.77 | |
| Baseline ART regimen [N = 89] | % AZT-based ϕ | 66% | 64% | 1.00 | 68% | 56% | 0.41 | 67% | 59% | 0.58 |
| % D4T-based ϕ | 33% | 20% | 0.31 | 30% | 28% | 1.00 | 29% | 29% | 1.00 | |
| % NVP-based | 81% | 71% | 0.40 | 83% | 60% | 0.08 | 83% | 60% | 0.08 | |
| % EFV-based | 19% | 29% | 0.40 | 17% | 40% | 0.08 | 17% | 40% | 0.08 | |
| Drug substitution, %Yes, [N = 84] | 57% | 30% | 0.04 | 55% | 27% | 0.08 | 54% | 29% | 0.14 | |
| Adherence to ART, % sub-optimal #, [N = 90] | 34% | 27% | 0.62 | 64% | 17% | 0.16 | 36% | 18% | 0.25 | |
| Treatment for Tuberculosis, %Yes [N = 90] | 33% | 31% | 1.00 | 31% | 39% | 0.58 | 30% | 41% | 0.40 | |
| Viral load at baseline, Log10 copies/mL, Median[IQR], [N = 90] | 3.8 (3.5–4.4) | 3.9 (3.7–4.7) | 0.47 | 3.8 (3.5–4.3) | 4.1 (3.8–5.1) | 0.16 | 3.8 (3.6–4.4) | 4.0 (3.8–5.1) | 0.29 | |
| Viral load at failure, Log10 copies/mL, Median[IQR], [N = 90] | 4.2 (3.8–4.7) | 4.3 (3.9–4.8) | 0.42 | 4.2 (3.8–4.7) | 4.4 (3.9–5.1) | 0.20 | 4.2 (3.8–4.8) | 4.8 (3.9–5.0) | 0.33 | |
1 Associations with p < 0.05 are bolded. * Height- and Weight-for-age Z score was measured using WHO Anthropomorphic Software [61], where a Z-score of <−2 is indicative of malnutrition. ϕ NRTIs used in ≤3 participants were not considered in this analysis. # Sub-optimal treatment adherence was defined using two self-reported methods: participant recall (number of pills missed in one week and one month) and using the Visual Analogue Scale (VAS) [90].