Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, India

Abstract

Background: Antiretroviral treatment (ART) consistently improved survival of people living with HIV and contributes to prevent new infections. In this study, we estimated the lifetime survival and examined the associated correlates of mortality amongst HIV-patients registered during 2007-11 in Andhra Pradesh, India. Methods: A total 63,882 adult HIV/AIDS cases (≥15 years) with complete follow-up information were extracted from ART database and included in the analysis. The Kaplan-Meier method was used to estimate the survival and Cox PH model was used to determine the relative hazard of mortality. Results: Nearly twelve percent (11.9%) of the total cases them (n=7,621) died during the follow-up period. Overall lifetime survival was estimated to 12.2 (95% C.I. 12.0-12.3) years. Multivariable Cox proportional hazard model indicated the mortality was significantly associated with age, CD4 count, gender, clinical stage and functional status. Conclusions: The scale-up of ART has resulted in substantial reductions in mortality and increased survival. Such information is useful for institution of intervention measures to reduce risk of death.

Incidence and predictors of mortality within the first year of antiretroviral therapy initiation at Debre-Markos Referral Hospital, Northwest Ethiopia: A retrospective follow up study

“…Patients with baseline ambulatory or bedridden functional status were about two fold at higher risk of death within the first year of HAART as compared to patients with working functional status at enrolment to ART (AHR = 2.18; 95% CI: 1.01, 4.74). This finding is agreed with other studies conducted in different parts of Ethiopia at different time periods, India, and China [ 20 , 28 , 29 , 35 – 39 ]. This is due to the fact that ambulatory or bedridden functional status is an indicator of low immune status.…”

“…Overall, 10.93% (95% CI: 8.72–13.62) of study participants were known to have died within a year of ART initiation. This is in line with studies conducted in Tigray (13.5%) and Somalia (9.8%), Ethiopia [ 24 , 28 ], and also study in India with 11.9% [ 29 ]. This similarity with Tigray and Somalia, Ethiopia, could be that they used similar HIV care and treatment guideline.…”

Prognostic Factors of Mortality among Adult Patients on Antiretroviral Therapy in India: A Hospital Based Retrospective Cohort Study

“…Previous studies using Cox regression analysis identified male gender [14, 15, 19, 23, 24], single marital status [11, 15], bedridden functional status [3, 11–13, 23], advanced WHO clinical stage [3, 8, 11–15, 22–25], underweight [11, 13, 14, 19], low CD4 count [3, 11, 14, 19, 22, 23], severe anaemia [8, 11, 14, 19, 22, 25], and older age [13, 15, 19, 23] as independent risk factors of mortality among PLHIV which was not seen in this study. There was no hazard difference for low and high CD4 count in this study, as three-fourth of the patients had CD4 count ≥200 cells per cu.mm.…”

Survival analysis and predictors of mortality among adult HIV/AIDS patients initiated antiretroviral therapy from 2010 to 2015 in Dubti General Hospital, Afar, Ethiopia: A retrospective cohort study

“…Although Anti-Retroviral Therapy (ART) plays a crucial role in terms of improving quality of life, reducing morbidity, and mortality of people living with HIV/AIDS, higher rates of AIDS related deaths were noticed in African countries compared to high income countries [ 3 ]. In addition, regional variation in survival status after ART initiation of people living with HIV/AIDS was observed in Ethiopia [ 4 ].…”