Survival of Persons Living With HIV/AIDS: A Multicentric Study From India

Abstract

aims: Persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) enrolled from antiretroviral therapy (ART) centers background: HIV patients enrolled from three different cities in India – Delhi, Pune and Kolkata, and were followed up at six monthly intervals objective: Monitoring the WHO stage, CD4 counts, complete blood counts and liver and kidney function tests, for a duration of three years method: This study was an ambi-spective cohort study involving three centers from India (Delhi, Kolkata, Pune). 1474 adult patients (>= 18 years of age) who were already enrolled in the ART program were enrolled in our study consecutively regardless of the clinical stage, CD4 counts, ART regimen or sociodemographic factors. The sample size was one of convenience. Enrolment started from November 2017 and was completed by February 2018. A total of 505 adult PLHA from the ART centre at AIIMS, New Delhi, 469 adult patients from B.J. Medical College Pune and 500 adults from Calcutta School of Tropical Medicine, Kolkata were enrolled and had a total follow-up duration of 36 months from enrolment. The study was completed in November 2020. result: The incidence of mortality among HIV/AIDS patients on ART was 5·0 per 1000 patient years (21/1410, 1.4%). Age at initiation of ART being above 35 years was the only significant predictor of mortality (log rank p = 0·018). Multivariable analysis showed significant association of an unfavourable outcome (defined as mortality or development of opportunistic infection during follow-up) with male gender (adjusted odds ratio (AOR) = 5.26, p = <0.01) and being unmarried at ART initiation (AOR = 1.39, p = 0.005). conclusion: The survival of PLHA with good adherence to ART is independent of the WHO stage or CD4 counts at initiation of ART. other: WHO