Survival and Predictors of Mortality Among HIV Positive Adult Patients on Highly Active Antiretroviral Therapy in Public Hospitals of Kambata Tambaro Zone, Southern Ethiopia: A Retrospective Cohort Study.
HAART
HIV/AIDS
low-resource setting
mortality
predictors
survival
Journal
HIV/AIDS (Auckland, N.Z.)
ISSN: 1179-1373
Titre abrégé: HIV AIDS (Auckl)
Pays: New Zealand
ID NLM: 101515943
Informations de publication
Date de publication:
2021
2021
Historique:
received:
26
12
2020
accepted:
26
02
2021
entrez:
19
3
2021
pubmed:
20
3
2021
medline:
20
3
2021
Statut:
epublish
Résumé
Human Immune Deficiency Virus (HIV) infection remains the leading cause of morbidity and mortality. In Ethiopia, despite test and treat all HIV positives are adopted, a significant number of people eligible for Anti-Retroviral Therapy (ART) show up with advanced disease and at lower CD4 count. There is currently paucity of studies conducted that investigate predictors of mortality among adults on ART in the study area. To explore Survival and predictors of mortality among adult HIV-positive patients on ART in Kambata Tambaro Zone, Ethiopia, from August 2013 to February 2019. A health facility-based retrospective cohort study was conducted among records of 467 adult HIV-positive patients on ART selected using simple random sampling. Data were collected using standardized abstraction tool. Kaplan-Meier, Log rank tests and Cox regression model was applied to estimate survival status and identify predictors of mortality, respectively. Of the total 467 study subjects, 59 (12.63%) of them died in the study period. The median follow-up time of the cohort was 40.1 (IQR=13.6-59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08-87.82) at 66 months. Bedridden function AHR=3.0 (95% CI, 1.44-6.64), Fair-adherence AHR=3.3 (95% CI, 1.50-7.07), Poor-adherence AHR=3.8 (95% CI, 1.88-7.96), presence of OIs AHR=4.2 (95% CI, 1.98-8.50), Late diagnosis (CD4 count >/=350) AHR=3.0 (95% CI, 1.91-6.42) and Immunologic failure AHR=3.5 (95% CI, 1.41-6.29) were independent predictors of time to death in Cox-Regression. Late Diagnosis, poor adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis to start treatment and emphasizing on close follow-up care to improve treatment adherence should be given special emphasis.
Sections du résumé
BACKGROUND
BACKGROUND
Human Immune Deficiency Virus (HIV) infection remains the leading cause of morbidity and mortality. In Ethiopia, despite test and treat all HIV positives are adopted, a significant number of people eligible for Anti-Retroviral Therapy (ART) show up with advanced disease and at lower CD4 count. There is currently paucity of studies conducted that investigate predictors of mortality among adults on ART in the study area.
OBJECTIVE
OBJECTIVE
To explore Survival and predictors of mortality among adult HIV-positive patients on ART in Kambata Tambaro Zone, Ethiopia, from August 2013 to February 2019.
METHODS
METHODS
A health facility-based retrospective cohort study was conducted among records of 467 adult HIV-positive patients on ART selected using simple random sampling. Data were collected using standardized abstraction tool. Kaplan-Meier, Log rank tests and Cox regression model was applied to estimate survival status and identify predictors of mortality, respectively.
RESULTS
RESULTS
Of the total 467 study subjects, 59 (12.63%) of them died in the study period. The median follow-up time of the cohort was 40.1 (IQR=13.6-59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08-87.82) at 66 months. Bedridden function AHR=3.0 (95% CI, 1.44-6.64), Fair-adherence AHR=3.3 (95% CI, 1.50-7.07), Poor-adherence AHR=3.8 (95% CI, 1.88-7.96), presence of OIs AHR=4.2 (95% CI, 1.98-8.50), Late diagnosis (CD4 count >/=350) AHR=3.0 (95% CI, 1.91-6.42) and Immunologic failure AHR=3.5 (95% CI, 1.41-6.29) were independent predictors of time to death in Cox-Regression.
CONCLUSION
CONCLUSIONS
Late Diagnosis, poor adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis to start treatment and emphasizing on close follow-up care to improve treatment adherence should be given special emphasis.
Identifiants
pubmed: 33737838
doi: 10.2147/HIV.S299219
pii: 299219
pmc: PMC7966412
doi:
Types de publication
Journal Article
Langues
eng
Pagination
271-281Informations de copyright
© 2021 Abuto et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interests for this work.
Références
AIDS Res Treat. 2017;2017:5415298
pubmed: 29214077
ISRN AIDS. 2013 Feb 20;2013:491601
pubmed: 24052890
Curr Opin HIV AIDS. 2017 Mar;12(2):123-128
pubmed: 28059957
BMC Infect Dis. 2013 Dec 26;13:604
pubmed: 24369908
AIDS Res Ther. 2012 May 18;9(1):15
pubmed: 22606951
Infect Dis Ther. 2014 Jun;3(1):1-17
pubmed: 25134808
PLoS One. 2014 Jan 31;9(1):e87392
pubmed: 24498093
J Infect Dis. 2003 May 15;187(10):1534-43
pubmed: 12721933
Indian J Med Res. 2014 Oct;140(4):491-500
pubmed: 25488442
Ethiop J Health Sci. 2017 Feb;27(Suppl 1):17-28
pubmed: 28465650
Pan Afr Med J. 2015 Jan 22;20:63
pubmed: 26090021
J Infect Dis. 2013 Dec 1;208(11):1784-93
pubmed: 23908475
Epidemiol Health. 2016 Nov 6;38:e2016049
pubmed: 27820957
BMJ Glob Health. 2016 Sep 15;1(2):e000010
pubmed: 28588933
PLoS Med. 2016 Nov 29;13(11):e1002183
pubmed: 27898679
PLoS One. 2017 Dec 15;12(12):e0189055
pubmed: 29244807
Pan Afr Med J. 2014 Feb 03;17:88
pubmed: 25452834
Pan Afr Med J. 2015 Oct 14;22:138
pubmed: 26889319
PLoS One. 2013 Jun 18;8(6):e66860
pubmed: 23825577
BMC Infect Dis. 2018 Jul 11;18(1):320
pubmed: 29996776
Trop Med Int Health. 2009 Jan;14(1):36-43
pubmed: 19017309
BMC Public Health. 2015 Aug 27;15:826
pubmed: 26310943
Ethiop J Health Sci. 2017 Feb;27(Suppl 1):63-71
pubmed: 28465654
Ethiop J Health Sci. 2019 Jan;29(1):859-868
pubmed: 30700953
AIDS. 2008 Oct 1;22(15):1897-908
pubmed: 18784453
AIDS Res Treat. 2015;2015:148769
pubmed: 25821596
HIV AIDS (Auckl). 2017 Sep 22;9:187-192
pubmed: 28989286
BMC Infect Dis. 2006 Sep 01;6:136
pubmed: 16948852
Int Sch Res Notices. 2014 Oct 09;2014:250913
pubmed: 27351014