Determinant of mortality in HIV infected people on antiretroviral therapy in Southwest Ethiopia

The introduction of antiretroviral drug has considerably reformed the course of HIV/AIDS from life threatening epidemic to a chronic manageable health problem. Mortality and morbidity associated with HIV/AIDS are changing. The main aim of this study was to assess the potential determinant of death among people infected with HIV and initiated anti-retroviral therapy (ART). A general retrospective cohort method was used on 2655 people undertaking ART at Mizan Hospital from 7 January, 2005 to 8 May, 2013 in Southern Ethiopia. The three age groups: Pediatrics (age under 10 years), teens (age between 11 and 19 years), and elderly (age older than 20 years) was used to stratify the cohort. The usual clinical follow-up registry of the ART clinic was the main data for the study. Kaplan-Meier (KM) method was used to compare the survival experience of patients after initiation of ART. Cox proportional regression model was used to assess determinant of mortality. A total of 2655 patients, consisting of 6.3% pediatrics, 3.3% teenagers and 90.4% elderly were included in the study. The survival probability at the sixth month after initiation of the treatment was 96, 94, 96 and 96% for pediatrics, teenagers and adults, respectively. A low initial CD4 (P=0.001), advanced WHO clinical disease stage (P=0.01), receiving ISONIAZID preventive prophylaxis (P=0.02), tuberculosis coinfection (P < 0.001) and being bedridden (P < 0.002) was an independent determinant of death. The cumulative incidence of mortality rate for HIV patients has been low in this study hence early initiation of the treatment is highly recommended.