Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
AIDS Res Ther. 2021 May 5;18(1):27. doi: 10.1186/s12981-021-00353-z.
Globally Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is an ongoing public health issue associated with high morbidity and mortality. Efforts have been made to reduce HIV/AIDS-related morbidity and mortality by delivering antiretroviral therapy. However, the incidence and predictors of mortality in border areas like Metema were not investigated. This study aimed to assess predictors of mortality rate among adult HIV-positive patients on antiretroviral therapy at Metema Hospital.
Retrospective follow-up study was employed among ART patients from January 1, 2013, to December 30, 2018. Data were entered in Epi-data 3.1 and exported to STATA 14 for analysis. Kaplan-Meier and Log-Rank test was used to compare survival differences among categories of different variables. In bi-variable analysis p-values < 0.20 were entered into a multivariable analysis. Multivariate Weibull model was used to measure the risk of death and identify the significant predictors of death. Variables that were statistically significant at p-value < 0.05 were concluded as predictors of mortality.
A total of 542 study participants were included. The overall incidence rate was 6.7 (95% CI: 5.4-8.4) deaths per 100 person-years of observation. Being male (HR = 2.4; 95% CI: 1.24-4.62), STAGE IV (HR = 5.64; 95% CI: 2.53-12.56), stage III (HR = 3.31; 95% CI: 1.35-8.10), TB-coinfection (HR = 3.71; 95% CI: 1.59-8.64), low hemoglobin (HR = 4.14; 95% CI: 2.18-7.86), BMI ≤ 15.4 kg/m (HR = 2.45; 95% CI: 1.17-5.10) and viral load > 1000 copy/ml (HR = 6.70; 95% CI: 3.4-13.22) were found to be a significant predictor for mortality among HIV patients on ART treatment.
The incidence of death was high. Being male, viral load, those with advanced STAGE (III & IV), TB co-infected, low BMI, and low hemoglobin were at a higher risk of mortality. Special attention should be given to male patients and high public interventions needed among HIV patients on ART to reduce the mortality rate.
在全球范围内，人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）是一个持续存在的公共卫生问题，与高发病率和死亡率有关。通过提供抗逆转录病毒疗法，已经努力降低与 HIV/AIDS 相关的发病率和死亡率。然而，像梅特马这样的边境地区的发病率和死亡率预测因素尚未得到调查。本研究旨在评估梅特马医院接受抗逆转录病毒治疗的成年 HIV 阳性患者的死亡率预测因素。
采用回顾性随访研究，对 2013 年 1 月 1 日至 2018 年 12 月 30 日期间在 ART 患者中进行。数据输入 Epi-data 3.1 并导出到 STATA 14 进行分析。Kaplan-Meier 和 Log-Rank 检验用于比较不同变量类别之间的生存差异。在双变量分析中，p 值<0.20 的变量被纳入多变量分析。多变量 Weibull 模型用于测量死亡风险并确定死亡的显著预测因素。p 值<0.05 的统计学显著变量被认为是死亡率的预测因素。
共纳入 542 名研究参与者。总发病率为 6.7（95%CI：5.4-8.4）每 100 人年观察到的死亡人数。男性（HR=2.4；95%CI：1.24-4.62）、IV 期（HR=5.64；95%CI：2.53-12.56）、III 期（HR=3.31；95%CI：1.35-8.10）、TB 合并感染（HR=3.71；95%CI：1.59-8.64）、低血红蛋白（HR=4.14；95%CI：2.18-7.86）、BMI≤15.4kg/m（HR=2.45；95%CI：1.17-5.10）和病毒载量>1000 拷贝/ml（HR=6.70；95%CI：3.4-13.22）被发现是接受 ART 治疗的 HIV 患者死亡的显著预测因素。
死亡率很高。男性、病毒载量、晚期（III 期和 IV 期）、TB 合并感染、低 BMI 和低血红蛋白的患者死亡风险更高。应特别关注男性患者，并需要在接受 ART 的 HIV 患者中开展更多的公共干预措施，以降低死亡率。
