Table 2.
Risk factors for virologic failure on second-line ART in univariate and multivariable logistic regression models
| Characteristic | Univariate analysis | Multivariable analysisa | ||
|---|---|---|---|---|
| OR (95% CI) | p | aOR (95% CI) | p | |
| Age | 0.97 (0.94–1.003) | 0.08 | ||
| < 40 | Ref. | Ref. | ||
| ≥ 40 | 0.84 (0.49–1.47) | 0.55 | 0.77 (0.42–1.41) | 0.40 |
| Gender | ||||
| Male | Ref. | Ref. | ||
| Female | 1.01 (0.55–1.85) | > 0.95 | 0.62 (0.29–1.30) | 0.21 |
| Time-updated CD4 count, cells/mm3 (per 50 cells/mm3 increase) | 0.83 (0.77–0.90) | < 0.0001 | ||
| Time-updated CD4 count, cells/mm3 | ||||
| > 350 | Ref. | Ref. | ||
| 200–350 | 3.67 (1.82–7.41) | < 0.0001 | 3.39 (1.63–7.05) | 0.001 |
| < 200 | 4.74 (2.34–9.60) | < 0.0001 | 4.15 (1.98–8.71) | < 0.0001 |
| Time on second-line ART, y | ||||
| ≥ 3 | Ref. | |||
| < 3 | 1.05 (0.59–1.85) | 0.85 | ||
| Marital status | ||||
| Not married | Ref. | |||
| Married | 1.04 (0.53–2.08) | 0.91 | ||
| Education level | ||||
| Illiterate and primary | Ref. | |||
| Secondary | 0.77 (0.41–1.45) | 0.42 | ||
| College and above | 0.67 (0.29–1.61) | 0.38 | ||
| Income, Indian rupeesb | ||||
| < 5000 | Ref. | |||
| 5000–10,000 | 1.33 (0.74–2.39) | 0.34 | ||
| > 10,000 | 0.51 (0.11–2.27) | 0.38 | ||
| Employed | ||||
| No | Ref. | |||
| Yes | 0.91 (0.48–1.75) | 0.79 | ||
| Smoking | ||||
| No | Ref. | |||
| Yes | 0.55 (0.23–1.34) | 0.18 | ||
| Alcohol use | ||||
| No | Ref. | |||
| Yes | 0.63 (0.29–1.40) | 0.26 | ||
| Past opportunistic infectionc | ||||
| No | Ref. | |||
| Yes | 0.96 (0.55–1.67) | 0.88 | ||
| Present opportunistic infectiond | ||||
| No | Ref. | Ref. | ||
| Yes | 6.73 (2.66–17.00) | < 0.0001 | 4.84 (1.77–13.24) | 0.002 |
| WHO stage at first-line failure | ||||
| I | Ref. | |||
| II | 2.14 (0.74–6.18) | 0.16 | ||
| III | 1.90 (0.67–5.38) | 0.23 | ||
| IV | 1.48 (0.41–5.41) | 0.55 | ||
| Weight at first line failure | 0.95 (0.92–0.98) | 0.004 | ||
| Weight at first-line failure, kg | ||||
| ≥ 51 | Ref. | Ref. | ||
| < 51 | 2.36 (1.32–4.22) | 0.004 | 2.67 (1.33–5.34) | 0.005 |
| Adherence > 95%e | ||||
| Yes | Ref. | Ref. | ||
| No | 2.66 (1.39—5.07) | 0.003 | 1.79 (0.86–3.67) | 0.12 |
| Protease inhibitor | ||||
| Lopinavir/ritonavir | Ref. | |||
| Atazanavir/ritonavir | 2.48 (0.32–19.2) | 0.38 | ||
ART antiretroviral therapy, aOR adjusted odds ratio, IQR interquartile range, OR odds ratio, WHO World Health Organization
aAdjusted for age, sex, time-updated CD4 count, present opportunistic infection, weight at first-line failure, and adherence > 95%
b5000–1000 INR = ~ 64–130 USD (As per May 2022 exchange rate)
cDefined as occurrence of opportunistic infection (including primarily Pulmonary Tuberculosis, Diarrhoea, Herpes Zoster, Candidiasis, Weight loss, Cryptococcal Meningitis, Others) prior to initiation of second line ART
dDefined as occurrence of opportunistic infection after initiation of second line ART
eCalculated as the number of pills consumed divided by the number of pills prescribed multiplied by 100