Predictors of Survival in HIV-Infected Patient after Initiation of HAART in Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Abstract

Introduction . ART has improved the survival of HIV-infected patients. However, patients in resource-poor countries have higher mortality rates, particularly the first months after initiating ART. In this study we tried to determine the survival factors in HIV-infected patients treated with HAART in Zewditu Memorial Hospital. Methods . A retrospective cohort study was conducted from 2008 to 2012. All HIV-infected patients above the age of 14 took first line ART. Data were collected, entered, and analyzed using Epi Info 7 and SPSS Version 20. Life table was used to estimate mortality after initiation of ART, and Kaplan-Meier was used to compare survival curves. Cox proportional hazards model was used to assess the predictors of mortality. Results . The incidence of mortality was 3.8/100 person-years. Independent predictors of mortality were WHO clinical stages 3-4 ( H R = 2.39 at 95% CI (1.26, 5.31)), anemia (hemoglobin level < 10 gm/dL ( H R = 5.54 at 95% CI (2.58, 11.86)). Conclusion . Incidence of mortality was found relatively low, majority of deaths occurring within 3 months of starting ART. WHO stages 3-4, anemia (hemoglobin count < 10 gm/dL), and past TB coinfection were the main predictors of mortality. The underlying causes for early death in patients presenting at late stages should be investigated.