Prognostic Factors of Mortality among Adult Patients on Antiretroviral Therapy in India: A Hospital Based Retrospective Cohort Study

Joseph, Nitin and Sinha, Ushasti and Tiwari, Nishtha and Ghosh, Pritha and Sindhu, Patneedi (2019) Prognostic Factors of Mortality among Adult Patients on Antiretroviral Therapy in India: A Hospital Based Retrospective Cohort Study. BioMed Research International, 2019 (1). pp. 1-10. ISSN 23146133

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Abstract

Introduction. HIV related deaths still continue to occur in large numbers in spite of good quality drugs being freely available in India.This study was therefore done to assess the prognostic factors of mortality among people living with HIV (PLHIV) on antiretroviral therapy (ART). Tis would help in planning strategies for further improving their survival. Materials and Methods. Record based data from baseline and follow-up visits of a cohort of patients aged above 14 years on ART was retrospectively reviewed over a seven-year period. Te Kaplan-Meier models were used to estimate life time survival probability, and Cox proportional hazard regression model was used to determine independent prognostic factors of death, among patients, afer initiation of ART. Results. Mean age of the total 285 patients enrolled in this study was 45.8±9.7 years. Mean duration of treatment on ART was 1127±611.8 days. During the follow-up period, 44/285(15.4%) patients died, resulting in incidence density of death rate as 3.12 per 100 person years. Good adherence with treatment was reported by 267(93.7%) patients. Nearly half of the deaths, i.e., 21(47.7%), occurred within three months of them starting ART. Te mean survival time afer initiation of ART was 2084.0±55.3 days (95% CI is 1975.5-2192.5). Te presence of opportunistic infections (OIs) and tuberculosis before and poor/average adherence to ART and alcohol usage afer starting ART were independent prognostic factors of mortality among patients. Conclusion. Several prognostic factors infuencing mortality among adult HIV patients receiving treatment were identifed in this study. Screening eforts is essential in early detection and management of OIs among PLHIV. Good counselling and monitoring is recommended to improve adherence and also to prevent alcohol usage afer initiation of ART. Such measures would help in further reducing mortality among HIV patients in the settings.

Item Type: Article
Uncontrolled Keywords: Prognostic factors, Mortality, HIV, Antiretroviral Therapy
Subjects: Medicine > KMC Mangalore > Community Medicine
Depositing User: KMCMLR User
Date Deposited: 23 Jan 2019 10:08
Last Modified: 23 Jan 2019 10:08
URI: http://eprints.manipal.edu/id/eprint/153107

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