Alene M, et al. - Researchers evaluated the incidence rate and predictive factors of second-line treatment failure among adults living with HIV in the Amhara region was determined. The final analysis included 1,011 adults on second-line antiretroviral therapy (ART) who were enrolled between February 2008 and April 2016 in this institution based retrospective follow-up study conducted from May to June 2017. Second-line treatment failure had an overall incidence of 9.86 per 100 person-years, indicating a high incidence rate in the study setting. Patients who didn’t change drug regimens, who had poor ART adherence, and who were not taking isoniazid showed a higher rate of second-line treatment failure. Findings thereby emphasize the essentiality of addressing significant predictors to prevent treatment failure among ART patients and the significance of sustainable monitoring to decrease the risk of treatment failure.