AIDS-duration predictors of HIV/AIDS patients on antiretroviral therapy at Debre Berhan referral hospital, north-central Ethiopia

Abstract

Background: Receiving ART treatment prolongs the life of HIV/AIDS patients by increasing substantially their CD4 count, even though the level is different from one individual patient to the other. The aim of this study was to identify the potential predictors of death of HIV-infected patients attending ART treatment. Methods: A hospital-based retrospective cohort chart review study design was conducted on 647 HIV-infected patients at a public hospital in North-Central Ethiopia from July 2012-January 2017. Kaplan-Meier plots, Log-rank and Wilcoxon tests, and Cox-proportional hazard model were employed. Data analysis was done with the help of statistical software (R version 3.2.2). 95% confidence interval for hazard ratio (HR) and p-value ≤ 0.05 was used to statistically associate with time till event occurred. Results: Among the total of 647 patients on 192(29.68%) event were occurred; while 455(70.32%) were censored. HIV-infected patients were followed for a total of 54 months, with a mean of 22.13(13.16) and a median of 21.47months. The prevalence of event was about 30 out of 100 HIV patients. According to the present study, the median CD4 count at the initial time of ART was 247 (IQR:120-375)cells/µl, whereas the median CD4 count at the time of event was 362 (IQR:225-532)cells/µl. Patients with higher baselineCD4 count,>200cells/µl were 32.10% lower in risk of death than patients with lower baselineCD4 count, < 200cells/µl (HR:0.679; 95%CI:0.537-0.857; p-value=0.001). Conclusions: ART treatment is effective enough in slowing down the progression of HIV-infection to AIDS and decreasing the mortality rate of patients significantly. Being Widowed/ divorced, bedridden, ambulatory began with lower baseline CD4 count and being on TDF-3TC-EFV regimen were the predictors of mortality in HIV-infected patients on ART. It is recommended that HIV patients start antiretroviral treatment early, track the progression of HIV to AIDS.