Belay Hadera, Alemseged Fessahaye, Angesom Teklit, Hintsa Solomon, Abay Mebrahtu
Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
Department of Epidemiology, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia.
HIV AIDS (Auckl). 2017 Sep 22;9:187-192. doi: 10.2147/HIV.S141895. eCollection 2017.
The global incidence of HIV infection is not significantly decreasing, especially in sub-Saharan African countries, including Ethiopia. Though there is availability and accessibility of free HIV services, people are not being diagnosed early for HIV, and hence patients are still dying of HIV-related causes. This research is aimed at verifying the effect of late diagnosis of HIV on HIV-related mortality in Central Zone Tigray, Ethiopia.
A retrospective cohort study among adult (≥15 years old) HIV patients in three general hospitals of Tigray was conducted. Record reviews were carried out retrospectively from 2010 to 2015. Sample size was determined using stpower Cox in Stata software. Data were entered into EpiData version 3.1 software and transferred to Stata version 12 for analysis. Both bivariable and multivariable analyses were performed using Cox regression model to compare the HIV-related mortality of exposed (cluster of differentiation 4 cells count <350 cells/mm) and nonexposed (≥350 cells/mm) patients using adjusted hazard ratio (AHR) at 95% confidence interval (CI).
In all, 638 HIV patients were analyzed, contributing 2,105.6 person-years. Forty-eight (7.5%) patients died of HIV-related causes with a mortality rate of 2.28 per 100 person-years. In the multivariable Cox regression model, patients with late diagnosis of HIV had a higher risk of mortality (AHR =3.22, 95% CI: 1.17-8.82) than patients with early diagnosis of HIV. Rural residence (AHR =1.96, 95% CI: 1.05-3.68), unemployment (AHR =2.70, 95% CI: 1.03-7.08), bedridden patients (AHR =2.98, 95% CI: 1.45-6.13), ambulatory patients (AHR =2.54, 95% CI: 1.05-6.15), and baseline hemoglobin level of <11 mg/dL (AHR =3.06, 95% CI: 1.51-6.23) were other independent predictors of mortality.
Late diagnosis of HIV increased HIV-related mortality. Rural residence, unemployment, bedridden and ambulatory patients, and baseline hemoglobin level <11 mg/dL were also independent predictors of HIV-related mortality.
全球艾滋病毒感染率并未显著下降，尤其是在包括埃塞俄比亚在内的撒哈拉以南非洲国家。尽管有免费的艾滋病毒服务且可获得，但人们并未得到艾滋病毒的早期诊断，因此患者仍死于与艾滋病毒相关的原因。本研究旨在验证埃塞俄比亚提格雷中部地区艾滋病毒晚期诊断对与艾滋病毒相关死亡率的影响。
在提格雷的三家综合医院对成年（≥15岁）艾滋病毒患者进行了一项回顾性队列研究。回顾性查阅了2010年至2015年的记录。使用Stata软件中的stpower Cox确定样本量。数据录入EpiData 3.1软件，并转移到Stata 12版本进行分析。使用Cox回归模型进行双变量和多变量分析，以比较暴露组（分化簇4细胞计数<350个细胞/mm）和非暴露组（≥350个细胞/mm）患者在95%置信区间（CI）下使用调整后风险比（AHR）的与艾滋病毒相关的死亡率。
总共分析了638名艾滋病毒患者，贡献了2105.6人年。4８名（7.5%）患者死于与艾滋病毒相关的原因，死亡率为每100人年2.28例。在多变量Cox回归模型中，艾滋病毒晚期诊断的患者比艾滋病毒早期诊断的患者有更高的死亡风险（AHR =3.22，95%CI：1.17 - 8.82）。农村居民（AHR =1.96，95%CI：1.05 - 3.68）、失业（AHR =2.70，95%CI：1.03 - 7.08）、卧床患者（AHR =2.98，95%CI：1.45 - 6.13）、非卧床患者（AHR =2.54，95%CI：1.05 - 6.15）以及基线血红蛋白水平<11mg/dL（AHR =3.06，95%CI：1.51 - 6.23）是其他独立的死亡预测因素。
艾滋病毒的晚期诊断增加了与艾滋病毒相关的死亡率。农村居民、失业、卧床和非卧床患者以及基线血红蛋白水平<11mg/dL也是与艾滋病毒相关死亡率的独立预测因素。
