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

Abstract Background: To estimate the survival and effectors of mortality among HIV/AIDS patients switch to second-line highly active antiretroviral therapy (ART) in rural China.Methods: A three years’ retrospective cohort study was conducted and HIV/AIDS patients switched to the second-line ART between January 2009 to December 2014 enrollment. The data collected from medical records and analysis using Kaplan-Meier statistics and COX regression models.Findings: A total of 2883 HIV/AIDS participants followed up for 8445 person-years, 183 (6.5%) died, 14(0.5%) lost follow-up and the mortality rate 2.17/100 person-years. After adjusting other confounding factors by multivariable COX regression, age older than 50 years (HR,3.37; 95%CI, 1.92-5.92), Traditional Chinese medicine therapy (HR,0.48; 95%CI, 0.33-0.71), CD4 cell count littler than 200 cells/μl (HR,2.97; 95%CI, 1.90-4.64), AST or ALT higher than 50 u/L (HR,1.55; 95%CI, 1.15-2.11) were each independently associated with mortality among HIV/AIDS patients switch to second-line ART.Conclusions: Our retrospective cohort study indicates that mortality among HIV/AIDS patients switch to second-line ART lower than most other studies. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results. The result of our study suggest that Chinese therapy was potential treatment for HIV/AIDS patients.

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Time to initial highly active antiretroviral therapy discontinuation and its predictors among HIV patients in Felege Hiwot comprehensive specialized hospital: a retrospective cohort study

AIDS Research and Therapy ◽

10.1186/s12981-021-00418-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Tewodros Getnet Amera ◽

Kassawmar Angaw Bogale ◽

Yibekal Manaye Tefera

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Retrospective Cohort ◽

Clinical Stage ◽

Hiv Patients ◽

Therapy Discontinuation ◽

Highly Active ◽

Specialized Hospital ◽

Initial Regimen

Abstract Background Anti-retroviral therapy regimen discontinuations become a big challenge and cause diminishing the clinical and immunological benefit of treatment in Ethiopia. It reduces both the duration and the chance of viral control due to cross-resistance between different alternative drugs and overlapping toxicity between and within a class of antiretroviral drugs in Ethiopia. However, information’s on the time of initial regimen discontinuation and its predictors are not well studied. Objective This study aimed to assess the time to initial highly active antiretroviral therapy discontinuation and its predictors among HIV patients in Felege Hiwot comprehensive specialized hospital, North West Ethiopia. Method Institution-based retrospective cohort study was conducted among 418 HIV patients who started HAART from January 1, 2014, to December 31, 2019. Data were collected from the patient chart using a data extraction tool. The Kaplan–Meier curve was employed to compare survival rates. Multivariable Cox proportional hazard regression was applied to identify independent predictors of time to initial regimen discontinuation. Result A total of 418 patients on anti-retroviral therapy were followed. Incidence of initial HAART discontinuation was 16.7/100 person year. The median survival time was 3.5 years. Predictors showed association for time to initial HAART discontinuation were taking > 1 ART pills/day (AHR = 4.1, 95% CI 3.0–6.5), baseline CD4 count < 100 cells/mm3 (AHR = 2.6, 95% CI 1.5–4.7), 100–199 cells/mm3 (AHR = 2.2, 95% CI 1.2–4.0), baseline WHO clinical stage IV (AHR = 2.68, 95% CI 1.6–4.3) and stage III (AHR = 2.6, 95% CI 1.4–4.3) and TB infection (AHR = 2.3, 95% CI 1.6–3.5). Conclusion Most of the discontinuation occurred after 1 year of initiation of HAART. Baseline WHO clinical stage, TB infection, baseline CD4 count, and taking > 1 ART pill/day were found predictors of initial HAART regimen discontinuation. Work on early detection of HIV before the disease is advanced and initiation of one ART regimen daily is vital for survival on the initial regimen.

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