Virological failure and associated factors among children receiving anti-retroviral therapy, Northwest Ethiopia

BACKGROUND: Virological failure is under-recognized issue among children living with human immunodeficiency virus in developing countries. This partly may lead to failure to achieve the global goal of 90-90-90 targets in most developing countries including Ethiopia. OBJECTIVES: This study aimed to assess the virological failure and its predictors among children receiving antiretroviral therapy at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia. METHODS: An institutional based cross-sectional study was conducted among 253 study cohorts from January 2020-April 2021. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview, while detailed clinical data of the children were collected by reviewing the medical record. About 5 ml of blood were collected for the analysis of complete blood count and viral load quantification. Data were analyzed using SPSS version 20 and variables at p-value < 0.05 in the multivariable analysis were considered as statistically significant. RESULTS: In this study, the viral load suppression rate among antiretroviral therapy experienced children was 68.8%. Meanwhile, the overall virological failure among study participants was 19.4%. Children living without family (AOR = 3.63; 95%CI: 1.27–10.24), children with unemployed family (AOR = 4.95; 95%CI: 1.74–14.12), being wasted (AOR = 3.02; 95%CI: 1.19–7.67) being stunted (AOR = 2.38;95%CI:1.03–5.46), anemia (AOR = 5.50:95%CI;1.37–22.04) and being lymphopenic (AOR = 2.69:95%CI;1.04–7.75) were significantly associated with virological failure among children under treatment. CONCLUSION: Higher virological failure among children was noteworthy in the present study. Caretakers other than immediate family, unemployed family, wasted, stunted, anemia, and lymphopenia were significant independent predictors of virological failure. Hence, standard, and optimal management of children under treatment should be warranted.