Survival Status and Time to Death among Adult HIV Patients Attending ART in Jimma University Medical Center

Abstract

Background: Despite the world has efforts, the reduce acquired immunodeficiency syndrome (AIDS) related mortality by giving antiretroviral therapy (ART), HIV/AIDS is still killing people while they are on ART. However, the current progress and associated factors of mortality among ART-taking patients are hardly available. Therefore, this study aimed to determine predictors of mortality and time to death among HIV-infected adult patients after starting antiretroviral therapy at Jimma University Medical Center, southwest, Ethiopia. Methods: A retrospective cohort study was conducted involving all patients seen were reviewed between January,2017 to December, 2021. The study was conducted from May 18 to June 18, 2023, GC. The sample size was 642 and by using systematic sampling data were collected using questionnaires and secondary data... The data were entered in Epi-data, 3.1, and exported to SPSS version 25.0 for analysis. Kaplan-Meier and Log-rank test was used to compare the survival times of different groups of patients. In bi-variable analysis p-values <0.25 were candidates for multivariable analysis. Cox proportional hazards regression models were performed to identify the independent predictors for mortality. Variables those were statically significant at p-values < 0. 05 were concluded as predictors of mortality. Results: From a total of 642 ART patients who participated in the study, 114(17.8%) were deaths and the median survival time for an event (dead) case was 34 months with mean (SD) age at baseline 36.8(3.56) years and median age 43 years with the death incidence rate of 1.69 per 1000 person- months. Poor ART adherent patients (AHR = 2.43: 95% CI: 1.33- 4.43), WHO Stage IV (AHR=5.32: 95%CI: (1.24, 12.49), baseline weight of less than 40kg (AHR=3.23: 95% CI: (1.35, 7.71) and HIV disclosure status (AHR=1.58: 95%CI: (1.08-2.43) were independent predictors of mortality among ART patients. Conclusion and recommendation: The risk of mortality is increased if the HIV patient is at a lower baseline weight, WHO Clinical stage IV, and non-disclosure HIV patients, and who have had poor adherence. The researcher suggests that Strengthening ART care centers, improving community awareness of people living with HIV/AIDS, timely diagnosis, and early initiation for treatment may be necessary to increase patient survival.