Causes and predictors of hospitalization and in-hospital mortality among HIV/AIDS patients on highly active antiretroviral therapy in secondary and tertiary care hospitals in Oromia Regional State: multi-center cross-sectional study

Abstract

Introduction: Highly active antiretroviral therapies (HAART) decrease the incidence, morbidity, and mortality of acquired immunodeficiency syndrome (AIDS) dramatically. However, current research reported an increased hospitalization rate among AIDS patients. Therefore, this study aimed to determine causes and predictors of hospital admission as well as in-hospital mortality amongst human immunodeficiency virus (HIV)/AIDS-infected patients on HAART. Material and methods: This was a multi-center cross-sectional study, and included HIV/AIDS patients who were admitted to secondary and tertiary care hospitals in Oromia Regional State from May 1, 2017, to August 30, 2017. Data were collected from hospitalized HIV/AIDS patients using structured checklist and interview. Results were analyzed with Statistical Package for Social Sciences (SPSS) software, version 22. Bivariate and multivariable logistic regression analysis were performed to evaluate association, and p-value < 0.05 was used to determine relationship between dependent and independent variables. Results: Out of 171 participants enrolled, 105 (61%) were hospitalized due to opportunistic infections. Age ranged from 40 to 49 (AOR = 0.30; 95% CI: 0.09-0.98%) vs. 18-29, females (AOR = 2.41; 95% CI: 1.11-5.24%), CD4+ count less than 200 (AOR = 10.32; 95% CI: 3.49-30.52%), and poor adhered (AOR = 2.78; 95% CI: 1.21-6.41%) were significantly related to hospitalization with opportunistic infections (AIDS-related illnesses). Among admitted patients, 20 (11.7%) died in hospital. Poorly adherent patients and those who spent 9 days or more in hospital were more exposed to in-hospital death, with AOR = 3.093; 95% CI: 1.012-9.453% and AOR = 4.533; 95% CI: 1.371-14.985%, respectively. Conclusions: The major causes of hospitalization were HIV/AIDS-related illnesses. Adherence to the HIV drug regimen is warranted to minimize hospitalization with opportunistic infections and HIV/AIDS mortality. HIV AIDS Rev 2021; 20, 2: 102-108 DOI: https://doi.org/10.5114/hivar.2021.107236