Factors Affect the Survival Status of HIV Infected Patients under ART: The Case of Wolisso Catholic Hospital, Wolisso, Ethiopia, 2016.

Abstract

INTRODUCTION: Monitoring the length of survival after diagnosis is, therefore, an important component of the surveillance of AIDS. It provides a basis for evaluating individual prognostic factors. The survival of patients with AIDS may depend on a variety of factors that are socio-demographic and clinical factors. The study is designed to identify factors that affect the survival status of HIV infected patients under ART in Wolisso, Ethiopia. METHODS: This is a retrospective study based on cases of HIV infected patients of age 15 years and above who have started ART from September 2010 to August 2013 and followed until February 30th, 2014. To analyze the data descriptive statistics, univariate and multivariate analyses were used. The descriptive analysis indicates that out of the total of 658 HIV-infected patients, 533(81%) are censored and 125(19%) are uncensored in the study. And, from 125 uncensored patients, 60(9.1%) patients have died and 65(9.9%) are dropped out cases. The overall mean estimated survival time of patients under the study was 33.76(95% CI: 32.6-34.9) months.RESULTS: The Kaplan Meier method was used to estimate the survival time and Cox’s regression model was employed to identify the covariates that have a statistically significant effect on the survival of HIV-infected patients. Based on the log-rank test, there was a significant difference in survival experience between the various categories of gender, marital status, work type, duration of pre-ART, regimen type, functional status, TB type, WHO clinical stage, condom use, and substance abuse (like smoking or alcoholic). And, the multivariate analysis of the Cox regression model gives that CD4 count, functional status, TB type, WHO clinical stage, condom use, and substance abuse are significant risk factors for survival of HIV-infected patients. CONCLUSION: The patients with low CD4 count, WHO stage III or IV, being ambulatory or bedridden, extra-pulmonary, not used condom, and substance abuse were associated with a high risk of death or dropped out the ART of the patients. Therefore, it is recommended that these at-risk patients need careful monitoring to improve their survival times by the concerned bodies.

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

“…Patients who were using substances, such as alcohol, tobacco, and chat, or other drugs at baseline, showed almost a 2-fold higher risk of mortality compared to those who did not use substances (AHR = 1.79; 95% CI: 1.40-2.29%). In line, a previous study from Wolisso and Gonder in Ethiopia, revealed that patients who were using substances, like alcohol, tobacco, and chat usage, or other drugs at baseline, presented a 2-fold higher risk of mortality compared to patients who did not use substances [10,11,17,27]. This might be that alcohol, tobacco, and chat, or other drugs utilization can affect patients' immune system, and may speed up the progression of the disease.…”

“…Another study conducted in Tanzania showed TB as a strong predictor of mortality; patients with past TB co-infection had nearly 15-times higher risk of dying as compared to those who did not have TB co-infection. Similar study conducted in Wolisso in central Ethiopia reported past TB co-infection as a predictor of mortality [17]. This might be that delay in diagnosis and treatment as well as no TB prophylaxis contributed to higher mortality.…”

“…Another study conducted in Debremarkos in northern Ethiopia indicated that baseline ambulatory and bedridden functional status had 2.7-and 2.4-times higher risk of death than working patients, respectively [14,30]. Several other studies have also found an association between functional status and mortality of HIV/AIDS-infected patients [10,15,17,20,22,30]. Therefore, patients who present with ambulatory and bedridden functional status should obtain particular attention in order to reduce their mortality rate.…”