Survival analysis and predictors of mortality for adult HIV/AIDS patients following antiretroviral therapy in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: a retrospective cohort study

Abstract

Introduction: Acquired immune deficiency syndrome (AIDS) is a medical condition caused by human immunodeficiency virus (HIV), and has been the major concern worldwide. Despite antiretroviral treatment (ART) treatment showing significant clinical importance by meeting the goal of therapy, there is still a number of deaths due to socio-economic, demographic, and health-related factors. Therefore, this study was aimed to investigate the survival status and predictors of mortality for adult HIV-positive patients treated with ART. Material and methods: A retrospective cohort study was conducted with 1,285 of HIV-infected patients aged 15 years and greater, who were enrolled in ART at Mizan-Tepi University Teaching Hospital from September, 2007 to January, 2015. A multivariable Cox regression model was applied to assess significant predictors of mortality. Results: During follow-up period, a total of 1,285 patients contributed to 59,237 person/year of followup, and 273 (21%) of the patients died, showing overall incidence rate of 4.6 per 1,000 persons/ year (273/59,237). The median follow-up period was 44 months. During follow-up, 273 (21%) patients died, of whom nearly 32% and 12% of deaths occurred within 6 months and between 6 and 12 months of highly active antiretroviral therapy (HAART) initiation, respectively. Conclusions: Multivariable Cox proportional hazards model revealed that having concomitant tuberculosis infection, low baseline CD4 count, low baseline weight, living in rural area, using of a substance, older age, lower educational level, higher World Health Organization (WHO) clinical stages, functional status, and marital status were all significantly associated with progression to death for HIV/AIDS-infected patients. HIV AIDS Rev 2022; 21, 1: DOI: https://doi.org/10.5114/hivar.2022.112758