Incidence of Mortality and Its Predictors Among HIV Positive Adults on Antiretroviral Therapy in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

Background: Despite the accessibility and higher coverage of antiretroviral therapy (ART), HIV/AIDS is a leading cause of morbidity and mortality in low- and middle-income countries. Ethiopia also shares the high burden of HIV/AIDS-related morbidity and mortality. Therefore, this study aimed to assess the incidence of mortality and its predictors among adult HIV patients on ART in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.

Patients and methods: A retrospective follow-up study was conducted from January 2015 to January 2019 at the University of Gondar Comprehensive Specialized Hospital. A total of 475 patients who were on follow-up in this Hospital were included. The Cox proportional hazard model was fitted to assess the predictors of mortality. Both crude and adjusted hazard ratio (AHR) with their 95% confidence interval (CI) were calculated to show the strength of association. In multivariable analysis, variables with a P-value <0.05 were considered as statistically significant predictors of mortality.

Results: In this study, a total of 45 (9.5%) patients died with an incidence rate of 5.3 [95% CI: 3.4-7.1] per 100 person-years of observation. In the multivariable Cox regression analysis, the last known WHO stage III/IV [AHR= 15.02; 95% CI: 5.79-38.92], being anemic at baseline [AHR = 2.21; 95% CI: 1.02-4.78], and fair last known adherence level [AHR = 3.29; 95% CI: 1.39-7.78] were found to be significant predictors of mortality.

Conclusion: In this study, the incidence of mortality was relatively high. The rate of mortality may be minimized by paying particular attention to individuals with advanced WHO stage, anemia at the baseline, and those with adherence problems.

Keywords: HIV/AIDS; antiretroviral therapy; mortality.