article · HIV/AIDS - Research and Palliative Care
This retrospective study evaluated the survival rates and predictors of death among adult HIV/AIDS patients starting highly active antiretroviral therapy at Debre Berhan Referral Hospital in Ethiopia. By analysing the records of 447 randomly selected adult patients between 2013 and 2018, the study determined that 12.1% of patients died, yielding a crude death rate of 4.18 per 100 person-years. The overall estimated survival rate reached 81.7% over 72 months of follow-up. The risk of mortality was significantly higher among patients with clinical stage IV disease, baseline opportunistic infections, baseline haemoglobin levels under 10 mg/dL, and baseline CD4 counts below 200 cells per microlitre. Additional independent risk factors identified included the presence of comorbidities, being widowed, and having a bedridden functional status at the start of treatment.
Understanding which factors increase the risk of death for individuals starting antiretroviral therapy allows healthcare providers to identify high-risk individuals early. Pinpointing clinical markers such as low haemoglobin, low CD4 counts, and advanced disease stages helps clinics tailor monitoring and prioritise resources for patients who need the most urgent care, ultimately improving long-term survival.
The abstract does not indicate an application pathway or commercial product.
AI-generated from the published abstract. Always read the original work before citing.
BACKGROUND: Acquired immune deficiency syndrome is one of the most destructive epidemics the world has ever witnessed. An estimated 36.9 million people were living with HIV in 2017. HIV/AIDS is the major contributing factor for morbidity and mortality in low- and middle-income countries. Although different studies on survival and predictors of mortality among HIV/AIDS patients after initiation of antiretroviral therapy were conducted, there are inconsistencies in the findings of those studies. Furthermore, to the authors' knowledge, there was a dearth of studies conducted in this study area. PURPOSE: The purpose of this study was to assess the survival and predictors of mortality among adult patients starting highly active antiretroviral therapy at Debre Berhan Referral Hospital, North Showa, Amhara, Ethiopia. PATIENTS AND METHODS: An institution-based retrospective study was conducted among the medical records of 447 study subjects' selected using simple random sampling from January 1t, 2013 to December 30, 2018. The data was collected using a structured data abstraction checklist and analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS: Among 447 adult patients, 54 patients (12.1%) had died, giving a crude death rate of 4.18 per 100 person years (95% CI=3.20-5.45). The overall estimated survival rate after initiation of antiretroviral therapy was 81.7% (95% CI=75.36-86.54%) at 72 months of follow-up. The independent predictors of mortality were clinical stage IV (HR=15.6, 95% CI=6.609-36.948), baseline opportunistic infections (HR=1.86, 95% CI=1.048-3.330), baseline Hgb<10 mg/dL (HR=4.655, 95% CI=2.253-9.619), baseline CD4<200 cells/µL (HR=4.71, 95% CI=2.275-9.751), the presence of comorbidity (HR=2.56 95% CI=1.391-4.740), being widowed (HR=3.475, 95% CI=1.412-8.550), and bedridden functional status (HR=3.069, 95% CI=1.111-8.480). CONCLUSION: Patients with opportunistic infections, advanced clinical stage disease, bedridden functional status, baseline Hgb<10 mg/dL, baseline CD4<200 cells/µL, and comorbidity should be given special care.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.2147/hiv.s274747
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
