SURVIVAL AND ITS PREDICTORS AMONG HIV POSITIVE ADULT PATIENTS ON ANTIRETROVIRAL THERAPY IN PUBLIC HOSPITALS OF KAMBATA TAMBARO ZONE, ETHIOPIA

Abstract

Background: - Human immunodeficiency Virus (HIV) positive peoples are dying with Acquired Immune Deficiency Syndrome (AIDS) related deaths. Despite treat and test all HIV positives was applied, number of people eligible for ART were come up with advanced disease and at lower CD4 count. However, survival rate and its predictors among adult HIV positive people was not well understood in Kambata Tambaro Zone. Thus this study aims to identify Survival time and its predictors among adult HIV positive patients on ART in Kambata Tambaro Zone. Objective: - To assess survival time and its predictors among HIV positive adults on Antiretroviral Therapy in Public hospitals of Kambata Tambaro Zone, Southern Ethiopia from August 11, 2013 to August 10,2018. Methods and Materials: - Institution based retrospective longitudinal study was conducted in all 467 adults HIV positive patients on ART follow-up between August 11, 2013 and August 10, 2018 for an additional 6 months. Data was entered into Epi data version 4.1 and exported to STATA version 14 for data processing and analysis. The assumptions of Kaplan-Meier curves was done to estimate survival probability and log rank tests was employed to compare and estimate survival curves. Semi-parametric (Cox regression) model was applied to identify predictors of survival. Result: - Out of 467 study subjects, 59(12.63%) were died until the end of study period. The mean and median follow-up time of the cohort was36.3 and 40.1 (IQR=13.6-59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08-87.82) at 66 months of follow-up. Bedridden functional status AHR=3.0 (95% CI, 1.44-6.64), Fair adherence AHR= 3.3 (95%CI, 1.50-7.07) and Poor adherence AHR= 3.8 (95% CI, 1.88-7.96), Opportunistic infection AHR=4.2 (95% CI, 1.98-8.50), late diagnosed (CD4 count >/=350) AHR= 3.0 (95%CI, 1.91-6.42) and Immunologic failure AHR= 3.5 (95% CI, 1.41-6.29) independent predictors of time to death in Cox Regression. Conclusion: - The median survival time of adult HIV positive patients on ART was 40.1 months. Late Diagnosis, not having Good adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis (test) to start treatment and emphasizing on close follow-up care on this might increase survival time of patients