Predictors of Anemia Among Adult HIV Positive Patients on First-Line Antiretroviral Therapy in Northwest Ethiopia: A Retrospective Follow-Up Study

Figures & data

Table 1 Sample Size Determination of Adult HIV/AIDS Patients on First-Line ART in Northwest Amhara Referral Hospitals, Ethiopia from December 2015 to December 2018

Assumptions	Probability of Event	Variables	Hazard Ratio	Probability of Withdrawal	Sample Size
Power =80 Significance level (α)=0.05 Allocation ratio 1:1 Two tailed	0.058	CD4 count	5.9	0.1	191
	0.4	Base line ART	1.52	0.1	498
	0.39	Chronic diarrhoea	2.0	0.1	237

Table 2 Socio-Demographic Characteristics of Adult HIV Patients on First-Line ART in Amhara Regional Referral Hospitals, Ethiopia from December 2015 to December 2018 (N=486)

Variables	Frequency	Percent
Age in years
15–24	76	15.6
25–34	194	40
35–44	142	29.2
≥45	74	15.2
Sex
Male	207	42.6
Female	279	58.4
Religion
Orthodox Christian	437	89.9
Muslim	36	7.4
Others*	13	2.7
Occupation
Unemployed	103	21.2
Employed	89	18.3
Daily laborer	24	5
Self-employed	270	55.5
Residency
Urban	348	71.6
Rural	138	28.4
Educational status
No education	128	26.3
Primary	121	24.9
Secondary and above	237	48.8
Marital status
Single	126	26
Married	195	40.1
Divorced	124	25.5
Widowed	36	7.4
Separated	5	1
Disclosure status
Disclosed	294	60.5
Not disclosed	192	39.5
Support group/caregiver
Yes	389	80
No	97	20

Note: *Others protestant, catholic.

Table 3 Baseline Clinical and Antiretroviral Medication-Related Information, Among Adult HIV Patients on First-Line ART in Amhara Regional Referral Hospitals, Ethiopia from December 2015 to December 2018 (N=486)

Variables	Frequency	Percent
Past opportunistic infection
Yes	148	30.45
No	338	69.55
CPT
Yes	267	55
No	219	45
IPT
Yes	183	37.65
No	303	62.35
TB/HIV co-infection
Yes	142	29.2
No	344	70.8
Baseline functional status
Working	334	68.7
Ambulatory/Bedridden	152	31.3
Adherence on ART
Good	328	67.5
Fair/poor	158	22.5
First-line drug regimen
Zidovudine based	164	33.74
Non –zidovudine based	322	66.26
Baseline clinical WHO stage
Stage I/II	259	53.3
Stage III/IV	227	46.7
Nutritional status
Underweight	130	27
Normal	299	61
Overweight	57	12
Baseline CD4 count
≤ 350 cells/mm3	285	58.64
> 350 cells/mm3	201	41.34

Figure 1 Kaplan–Meier failure hazard function of anemia among HIV/AIDS patients on the first-line ART in northwest Amhara referral hospitals, northwest Ethiopia, Ethiopia from December 2015 to December 2018.

Figure 2 Kaplan–Meier hazard curve by (A) CD4 count (B) first-line drug regimen of anemia among adult HIV/AIDS patients on the first-line ART in northwest Amhara referral hospitals, northwest Ethiopia, Ethiopia from December 2015 to December 2018.

Figure 3 Kaplan–Meier failure curve of by hospitals anemia in adult HIV/AIDS patients on the first-line ART in northwest Amhara referral hospitals, northwest Ethiopia, Ethiopia from December 2015 to December 2018.

Table 4 Results of Proportional Hazard Assumptions on Key Categorical Variables of Anemia in HIV/AIDS Patients on the First-Line ART in Northwest Amhara Referral Hospitals, Ethiopia from December 2015 to December 2018

Covariate	Chi-Square	Df	P-value
Sex	0.17	1	0.68
Residency	0.94	1	0.33
CPT	0.14	1	0.70
TB/HIV co-infection	1.25	1	0.26
Age in year	0.12	1	0.72
Occupational status	0.06	1	0.80
Marital status	0.2	1	0.65
First line drug regimen	0.33	1	0.56
IPT	0.12	1	0.73
Educational status	0.18	1	0.67
Baseline CD4 count	0.11	1	0.75
Baseline clinical WHO stage	3.28	1	0.07
Nutritional status	0.24	1	0.62
Global test	19	13	0.58

Table 5 Bivariable and Multivariable Cox-Regression Analysis for Predictors of Anemia Among Adult HIV Patients on First-Line ART in Amhara Regional Referral Hospitals, Ethiopia from December 2015 to December 2018 (N=486)

Variables Categories		Status		CHR (95% CI)	AHR (95% CI)
		Event	Censored
Age in year	15–24	39	37	1.49 (0.92,2.41)	1.54 (0.88,2.68)
	25–34	83	111	1.20 (0.79,183)	1.11 (0.72,1.72)
	35–44	73	69	1.50 (0.98, 2.33)	1.29 (0.83,2.01)
	≥45	30	44	1	1
Sex	Male	100	107	1	1
	Female	125	154	0.79 (0.60,1.04)	0.80 (0.60,1.05)
Educational status	No education	71	57	1	1
	Primary	56	65	0.86 (0.60,1.22)	0.94 (0.65,1.38)
	Secondary above	98	139	0.76 (0.56,1.04)	0.80 (0.57,1.14)
Occupation	Un employed	52	51	1.09 (0.72,1.65	0.94 (0.57,1.57)
	Employed	38	51	1	1
	Daily laborer	15	9	1.96 (1.08, 3.58)	1.43 (0.76, 2.70)
	Self-employed	120	150	1.04 (0.72,1.50)	0.93 (0.61,1.41)
Residency	Urban	159	189	1	1
	Rural	66	72	1.46 (1.1, 1.95)	1.29 (0.95, 1.74)
Marital status	Single	63	63	1.12 (0.80,1.56)	1.00 (0.68,1.48)
	Married	81	114	1	1
	Divorced	67	56	1.33 (0.96,1.84)	1.23 (0.86,1.76)
	Widowed	14	128	0.97 (0.55,1.72)	1.17 (0.65, 2.07)
TB/HIV-co-infection	Yes	69	73	2.01 (1.50,2.68)	1.99 (1.45, 2.74)**
	No	156	188	1	1
IPT prophylaxis	Yes	73	110	1.26 (0.95,1.66)	1.27 (0.95, 1.70)
	No	152	151	1	1
First-line drug regimen	Zidovudine based	102	62	1.69 (1.30, 2.20)	1.39 (1.1,1.85)**
	Non-zidovudine based	125	129	1	1
Baseline CD4 count	≤350 cells/mm^3	172	113	1.70 (1.25, 2.32)	1.7 (1.23,2.35)**
	>350 cells/mm^3	53	148	1	1
Baseline WHO stage	Stage I/II	108	151	1	1
	Stage III/IV	117	110	1.35 (1.05,1.76)	1.32 (1.01,1.74)**
CPT	Yes	125	142	1.19 (0.91,1.55)	1.32 (0.99,1.74)
	No	100	119	1	1
Nutritional status	Underweight	77	53	1.69 (1.27,2.25)	1.53 (1.14, 2.07)**
	Normal	129	170	1	1
	Overweight	19	38	0.76 (0.47,1.23)	0.92 (0.55, 1.53)

Note: **p-value <0.05 statistically significant.