Abstract:
Background: In resource poor countries like Ethiopia the survival of patients treated with
antiretroviral therapy depends on factors that might vary greatly with socio demographic,
clinical and behavioral risk factors. However, factors affecting survival among adult HIV
positive patients in Ethiopia are not fully investigated. Moreover, mortality has been high
particularly in the first three to six month of initiating antiretroviral therapy. To avoid such early
deaths, the identification of possible risk factors and potential causes of deaths are important.
Methods: A retrospective cohort study was conducted using 455 records of patients who were
enrolled on antiretroviral therapy in Sawla General Hospital and Sawla Health center from
September 2013 to August 2018. Socio demographic, clinical, immunological, behavioral data
and date of antiretroviral treatment initiation including date of follow up status were extracted.
Predictor variables were identified by fitting Cox’s proportional hazard model using backward
stepwise method and statistical significance variables were declared based on p-value < 0.05.
Results: A total of 455 adult HIV/AIDS patients on ART contributed to 867 person year of
observation and 299(65.7%) were alive & on treatment, 78(17.1%) were lost follow up,
44(9.7%) were transfer out and 34 (7.5 %) were died. The estimated mortality was 4.4%, 5.3%,
6.1%, 7%, 7.5% and 7.5% at 6, 12, 24, 36, 48 & 60 months of follow up period, respectively.
Out of 34 deaths, 20 (58.8 %) were died within the first 6 months of antiretroviral therapy
initiation. The overall incidence rate of mortality was 3.92 per 100 person years of observation.
In multivariate analysis age 45 and above (AHR: 3.72, 95% CI: 1.21-11.4), bedridden functional
status (AHR: 17.4, 95% CI: 6.21-48.79), poor ART drug adherence (AHR: 4.52,95% CI: 2.05-
9.96), Tuberculosis co- infection (AHR: 4.1, 95% CI: 1.84-9.13), non-disclosure(AHR: 4.9,
95% CI: 1.82-12.89) & severe anemia (AHR: 5.1, 95% CI: 1.81-14.21) were predictor of
survival and statistically significant association with mortality in HIV patients.
Conclusion: This study had identified the independent significant predictors of survival in
patients living with HIV/AIDS after initiation of HAART. These factors include Patients with
older age, tuberculosis co infection, bedridden functional status and severe anemia (hemoglobin
less than 7 mg/dl) should be monitored closely by their clinicians.
