Background Antiretroviral therapy has been highly associated with reduction in the incidence of mortality in HIV/AIDS patients over time. However, there is a regional variation in the extent of reducing the incidence of mortality in many developing countries including Ethiopia. Hence, this study was conducted to generate summary evidences-based data for incidence of mortality and determinants of mortality. Methods Articles were comprehensively searched on Pub Med, Google Scholar, Cochrane library, Scopus, and DOAJ databases using Boolean operators. A Dersimonian and Laird methods of random effect model was used to estimate incidence and determinants of mortality. Heterogeneity, publication bias and quality of each study were checked. Subgroup analysis was employed. Relevant data from each study were extracted. STATA software version 14 was used for all statistical analysis. Result A total of 21 articles were finally reviewed and analyzed. Incidence of mortality was found to be 5/100-person year of observation (95% CI: 4–5/100pyo). Most of the death (67%) occurred during the first year of HAART initiation. Baseline Advanced WHO clinical stage (PHR (Pooled Hazard Rate) 2.88; 95%CI: 2.2–3.8), low CD4 cells count (PHR 1.88; 95% CI: 1.5–2.4), low body weight (PHR 1.6; 95% CI: 1.2–2.2), low hemoglobin level (PHR 2.4; 95% CI: 1.7–3.4), presence of TB infection (PHR 2.9; 95% CI: 2.13–4.61), non – working functional status (PHR 3.9; 95% CI: 2.8–5.4), bad medication adherence (PHR 4.8; 95% CI: 3.2–7.2), lack of cotrimoxazole preventive therapy (PHR 1.5; 95% CI: 1.2–2.0), being male (PHR 1.4; 95% CI: 1.2–1.8) and older age (PHR 1.2; 95% CI: 1.04–1.41) were significantly associated with increased mortality in this study. Conclusion Incidence of mortality was high particularly early in the course of therapy. Advanced WHO clinical stage, CD4 cells count low body weight, low hemoglobin level presence of TB infection, bad medication adherence older age and non-working functional status were significant determinants of incidence of mortality. Comprehensive service and strict follow up should be given to avert this high rate of mortality.

Background Antiretroviral therapy has been highly associated with reduction in the incidence of mortality in HIV/AIDS patients over time. However, there is a regional variation in the extent of reducing the incidence of mortality in many developing countries including Ethiopia. Hence, this study was conducted to generate summary evidences-based data for incidence of mortality and determinants of mortality. Methods Articles were comprehensively searched on Pub Med, Google Scholar, Cochrane library, Scopus, and DOAJ databases using Boolean operators. A Dersimonian and Laird methods of random effect model was used to estimate incidence and determinants of mortality. Heterogeneity, publication bias and quality of each study were checked. Subgroup analysis was employed. Relevant data from each study were extracted. STATA software version 14 was used for all statistical analysis. ResultA total of 21 articles were finally reviewed and analyzed. Incidence of mortality was found to be 5/100-person year of observation (95% CI: 4 – 5/100pyo). Most of the death (67%) occurred during the first year of HAART initiation. Baseline Advanced WHO clinical stage (PHR (Pooled Hazard Rate) 2.88; 95%CI: 2.2 – 3.8), low CD4 cells count (PHR 1.88; 95% CI: 1.5 – 2.4), low body weight (PHR 1.6; 95% CI: 1.2 – 2.2), low hemoglobin level (PHR 2.4; 95% CI: 1.7 – 3.4), presence of TB infection (PHR 2.9; 95% CI: 2.13 – 4.61), non – working functional status (PHR 3.9; 95% CI: 2.8 – 5.4), bad medication adherence (PHR 4.8; 95% CI: 3.2 – 7.2), lack of cotrimoxazole preventive therapy (PHR 1.5; 95% CI: 1.2 – 2.0), being male (PHR 1.4; 95% CI: 1.2 – 1.8) and older age (PHR 1.2; 95% CI: 1.04 – 1.41) were significantly associated with increased mortality in this study. ConclusionIncidence of mortality was high particularly early in the course of therapy. Advanced WHO clinical stage, CD4 cells count low body weight, low hemoglobin level presence of TB infection, bad medication adherence older age and non-working functional status were significant determinants of incidence of mortality. Comprehensive service and strict follow up should be given to avert this high rate of mortality.

Reduced AIDS mortality has been linked to the advent of highly active antiretroviral medication. The previous reviews conducted in Ethiopia lack the overall rigor and clarity in the study methodology, reported results and statistical inference. The goal was to create a data summary from studies accomplished previously throughout the nation so that programmers and implementers could use to harmonize the current advanced intervention and direct health service providers to improve ART service provision packages. This data would provide a thorough update on the magnitude of mortality among HIV-infected patients taking HAART by combining 21 eligible articles. The study's heterogeneity, publication bias, and quality were examined. The statistical analysis used random-effects model in STATA version 14. The protocol was registered(CRD42019123380). As a result, the pooled mortality incidence was 5 per 100 person-years of observation (95% CI: 4–5 per 100 pyo). Two-thirds of deaths occurred within the first year of starting HAART. Clinical stage (Pooled HR = 3.15; 95% CI: 2.36–4.21), CD4 count (Pooled HR = 2.31; 95% CI: 1.83–2.93), hemoglobin level (Pooled HR = 3.05; 95% CI: 2.19–4.27), TB co-infection (Pooled HR = 3.08; 95% CI: 2.21–4.29), and functional status (Pooled HR = 4.86; 95% CI: 3.59–6.97) were factors in this study that were substantially linked to higher mortality. Mortality rates were high, especially early in the therapeutic process. Significant mortality risk factors were WHO clinical stage, CD4 count, poor hemoglobin, TB co-infection, and non-working functional status. This significant mortality rate could be avoided with comprehensive care and stringent monitoring.