Risk Factors Of Antiretroviral Treatment Failure Among Adolescents In Imo State.
INTRODUCTION
1.1 Background
Among many factors, Antiretroviral Therapy (ART) contributes significantly to change in the natural course of Human Immune Virus infection/Acquired Immune Deficiency Syndrome (HIV/AIDS) since its introduction in 1987.
Rather than its known short course to death in some individuals, ARTs have, as a matter of fact, transformed HIV/AIDS to a chronic disease with increasing potential for survival of cases.
However, if unchecked ART treatment failures can reverse the progress so far recorded toward the pre-ART era resulting in increase in morbidity, mortality and demand for second-line and the salvage drugs.
Of concern too is that a small proportion of strict adherers fail on therapy especially among those on unboosted protease inhibitors.
Generally, the adolescents (10-19 years) constitute an integral percentage of people living with HIV/AIDS (PLWHA).
This subpopulation of PLWHA possess inherent and circumstantial factors that can affect their capacities not to succeed while on therapy.
Such risk factors include: age, social economic status, peer influence, disclosure dilemma, risky cognitive and sexual behaviours, discrimination and stigmatization, gender disequilibrium on the adolescent girl, poor adherence, loss to follow up, treatment interruption and infection with HIV resistance strains before initiation of therapy.
Treatment failure to first line regimen is a negative treatment outcome, could be one or a combination of virological, immunological or clinical.
When PLWHA fail with first line therapy the main life-saving option becomes second line drugs. Second line and salvage antiretrovirals (ARVs) are replete with pills burden, drug toxicity, increase frequency of clinic visits, potentials for another failure, drug stock out and increased cost of research and ART production.
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