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. Key words: Anti-retroviral therapy, mortality, South Ethiopia.