Survival Time and Associated Factors Among Adults Living with HIV After Initiation of HAART in South Gondar, Northwest Ethiopia: A Retrospective Cohort.

ABSTRACT

BACKGROUND: Antiretroviral therapy consistently improves the survival of people living with HIV and contributes to preventing the development of new infections. Studies of antiretroviral therapy programs in Africa have shown a high mortality rate during the first 6 months after initiation of HAART in rural health facilities. This study looks at survival time and associated factors among adults with HIV in south Gondar, Northwest Ethiopia. METHODS: A 5-year retrospective cohort study design was conducted using patient records among 746 adults living with HIV/AIDS. A systematic random sampling technique was used to select respondents after proportional allocation was made for all health facilities included in the study. Epi-info version 7 and STATA 12 were used for data entry and analysis, respectively. Kaplan-Meier survival analysis was used to estimate mean survival time and a life table was used to estimate survival probability after initiation of HAART. RESULTS: A total of 746 respondents were followed for a median of 60 months. There were 102 (13.67%) deaths yielding an overall mortality rate of 2.59/1,000-person year observation (95% CI=0.02136-0.031736). Age of respondents >43 years (AHR=2.790; 95% CI=1.495-5.206), bedridden (AHR=9.57; 95% CI=3.87-23.64), past TB treatment (AHR=0.86; 95% CI=0.46-0.609), baseline WHO stage IV (AHR=3.02; 95% CI=1.77-5.18), pneumonia after ART start (AHR=3.6; 95% CI=1.4-9.2), INH prophylaxis (AHR=2.58; 95% CI=1.232-5.188), ambulatory functional status (AHR=5.86; 95% CI=2.67-12.86), and disclosure status (AHR=0.423; 95% CI=0.261-0.685) were significant predictors for survival time after initiation of HAART among adults living with HIV. CONCLUSION: The mortality rate was highly (13.67%) observed in the early phase of antiretroviral treatment. Being ambulatory and bedridden, age of respondents >43 years, past TB treatment, baseline WHO stage IV, pneumonia after HAART, INH prophylaxis, and disclosure status were independent predictors of mortality.