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.

Factors associated with progression from HIV to death in patients receiving antiretroviral therapy in Southern Iran: a 21-year survival analysis and follow-up study

“…Acquired immune deficiency syndrome (AIDS) is currently one of the serious public health challenges worldwide [1]. AIDS is defined as the last stage of the disease that deteriorates immune system and makes the patient susceptible to opportunistic infections [2].…”

“…AIDS is defined as the last stage of the disease that deteriorates immune system and makes the patient susceptible to opportunistic infections [2]. The disease is responsible for socio-economic crises, reduction in life expectancy, and devastating costs to health services [1]. The United Nations program on HIV/AIDS (UNAIDS) reported that in 2021, 37.7 million people were living with human immunodeficiency virus (HIV) worldwide [3].…”

“…To date, despite international scientific efforts, no cure is available for HIV/AIDS. However, with the introduction of antiretroviral therapy (ART), HIV infection has evolved from an acute and fatal disease to a chronic illness [1]. ART reduces transmission (by preventing viral replication and increasing immune function), complications, drug resistance, and mortality [6].…”