Survival Time and Immunological Recovery of AIDS Patients Under Antiretroviral Treatment: a Case Study at Felege Hiwot Referal Hospital, Bahir-Dar, Ethiopia.
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Date
2014-06
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Addis Abeba university
Abstract
Antiretroviral Treatment (ART), although not a cure, can help people from becoming ill for
many years and this has improved the survival and recovery time of HIV patients. In 2011 a
number of 249,174 adults were on ART in Ethiopia. Although ART treatment has decreased HIV
associated mortality and morbidity, a number of patients still die after the start of ART. The
purpose of this study was to identify factors affecting the survival time and time to
immunological recovery of HIV/AIDS patients under ART treatment. A sample of 387 patients
was taken from patients’ records at Bahir-Dar Felege-Hiwot Referral Hospital from June 2006 to
August 2013. Kaplan-Meier estimation method and Cox proportional hazard model were applied
to describe and analyze the data. Females, baseline CD4 count >200cell/μl, TB-negative, total
lymphocyte count ≥1200 cell/mm3 and baseline weight ≥45kg, no regimen change, good
adherence to treatment, WHO stage I, working functional status and negative-anemia were
identified with longer survival time and shorter recovery time at 5% of significance level.
Patients having no risk behaviors lived longer. Based on the Cox regression model results the
adjusted HRs were as follows: high CD4 count (aHR=0.99), negative-anemia patients
(aHR=0.27), good adherence to treatment (aHR=0.10), fair adherence to treatment (aHR=0.47),
male gender (aHR=1.81), TB-positive (aHR=3.58), bedridden functional status (aHR=5.07),
ambulatory functional status (aHR=1.30). The adjusted HRs for recovery time were as follows:
patients with high CD4 count (aHR=1.02), high weight (≥45kg.) (aHR=1.03), WHO stage I
(aHR=1.88), WHO stage II (aHR=1.67) and negative-anemia (aHR=1.34) had shorter time to
immunological recovery at 5% level of significance. Male gender (aHR =0.73), old age
(aHR=0.98), total lymphocyte count <1200 (aHR=0.77) and regimen change (aHR=0.688) were
significantly associated with extended time to immunological recovery at 5% level.