Table 3.
Predictors of Confirmed Virological Failure Among Participants Initiating Antiretroviral Therapy
| Crude Analysis | Multivariable Analysisa | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Characteristic | Virologic Failure, no./No. (%) | PY | Rate per 100 PY (95% CI) | HR | (95% CI) | P Value | Adjusted HR | (95% CI) | P Value |
| Total sample | 60/1901 (3.2) | 2103.6 | 2.9 (2.2–3.7) | … | … | … | … | ||
| CD4 count, cells/μL | < .0001 | < .0001 | |||||||
| <200 | 35/477 (7.3) | 499.6 | 7.0 (5.0–9.8) | 4.10 | (2.41–7.00) | < .0001 | 3.49 | (2.00–6.14) | < .0001 |
| 200–499 | 23/1024 (2.2) | 1163.2 | 2.0 (1.3–3.0) | Ref | … | Ref | … | ||
| ≥500 | 2/400 (0.5) | 440.8 | 0.5 (.1–1.8) | 0.20 | (.05–.84) | .028 | 0.23 | (.05–.97) | .045 |
| Age, y | .10 | .29 | |||||||
| 18–24 | 6/310 (1.9) | 345.4 | 1.7 (.8–3.8) | 0.54 | (.23–1.26) | 0.75 | (.32–1.78) | ||
| 25–49 | 53/1453 (3.6) | 1613.8 | 3.3 (2.5–4.3) | Ref | … | Ref | … | ||
| ≥50 | 1/138 (0.7) | 144.4 | 0.69 (.1–4.9) | 0.22 | (.03–1.60) | 0.22 | (.30–1.65) | ||
| Sex | |||||||||
| Female | 37/1305 (2.8) | 1456.7 | 2.5 (1.8–3.5) | Ref | … | Ref | … | ||
| Male | 23/596 (3.9) | 651.9 | 3.5 (2.3–5.3) | 1.40 | (.84–2.37) | .196 | 0.85 | (.49–1.48) | .569 |
| Baseline WHO stage | .0001 | … | .085 | ||||||
| I/II | 36/1561 (2.3) | 1736.1 | 2.1 (1.5–2.9) | Ref | … | Ref | … | ||
| III | 19/278 (6.8) | 298.4 | 6.4 (4.1–10.0) | 3.07 | (1.76–5.35) | 2.10 | (1.07–4.10) | ||
| IV | 5/44 (11.4) | 52.9 | 9.5 (3.9–22.7) | 3.48 | (1.35–8.98) | 2.00 | (.70–5.71) | ||
| Pregnancy | |||||||||
| Nonpregnant women | 36/1203 (3.0) | 1341.1 | 2.7 (1.9–3.7) | Ref | … | … | … | ||
| Pregnant woman | 1/102 (1.0) | 110.6 | 0.9 (.1–6.4) | 0.33 | (.05–2.41) | .275 | … | … | |
| Baseline TB treatment | |||||||||
| No | 47/1694 (2.8) | 1886.0 | 2.5 (1.9–3.3) | Ref | … | Ref | … | ||
| Yes | 13/207 (6.3) | 217.7 | 6.0 (3.5–10.3) | 2.46 | (1.33–4.54) | .004 | 0.97 | (.45–2.05) | .927 |
| Regimen first NRTI | .71 | ||||||||
| Tenofovir | 58/1850 (3.1) | 2043.7 | 2.8 (2.2–3.7) | Ref | … | … | … | ||
| Zidovudine | 1/16 (6.3) | 22.9 | 4.4 (.6–31.0) | 1.28 | (.17–9.26) | … | … | ||
| Stavudine | 1/14 (7.1) | 16.7 | 6.0 (.8–42.6) | 2.15 | (.30–15.6) | … | … | ||
| Regimen NNRTI | |||||||||
| Efavirenz | 59/1857 (3.2) | 2062.5 | 2.9 (2.2–3.7) | Ref | … | … | … | ||
| Nevirapine | 1/24 (4.2) | 23.2 | 4.3 (.9–30.6) | 1.72 | (.24–12.47) | .591 | … | … | |
| Previous ART exposure | |||||||||
| No | 58/1857 (3.1) | 2058.9 | 2.8 (2.2–3.6) | Ref | … | … | … | ||
| Yes | 2/44 (4.6) | 44.7 | 4.5 (1.1–17.9) | 1.64 | (.40–6.74) | .491 | … | … | |
| Year of starting ART | |||||||||
| 2014 | 31/578 (5.4) | 893.5 | 3.5 (2.4–4.9) | Ref | … | … | … | ||
| 2015 | 29/1323 (2.2) | 1210.1 | 2.4 (1.7–3.4) | 1.20 | (.66–2.12) | .540 | … | … | |
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; HR, hazard ratio; NNRTI, nonnucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; PY, person-years; TB, tuberculosis; WHO, World Health Organization.
aThe multivariable model included baseline CD4 cell count category, age, sex, baseline WHO stage, and concomitant TB at baseline. Crude and adjusted models were stratified by site.