In Ethiopian clinical failure may be diagnosed if there is a new or recurrent clinical event indicating WHO clinical stage IV condition OR WHO clinical stage III conditions with pulmonary Tuberculosis (TB) and severe bacterial infections whereas Immunological failure is recorded if CD4 count at or below 250 cells/mm3 following clinical failure Or Persistent CD4 levels below 100 cells/mm3 and VF is defined as having Viral load above 1000 copies/mL based on two consecutive viral load measurements after 6 months of treatment start9. Here, CD4 is linked to bacterial infectious disease.