Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study

Figures & data

Table 1 Socio-Demographic Characteristics of the Study Participants of Adult HIV Patients on ART at Wolaita Sodo Comprehensive Specialized Hospital, Southern Ethiopia, 2021

Variables	Category	Censored (N=388)	Death (N=53)	PYO	IDR/100
Sex	Male	146(82.49)	31(20.18)	385	8.05
	Female	242(91.67)	22(8.33)	558.16	3.94
Age	15–24	59 (93.65)	4(6.35)	150.2	2.66
	25–34	172(88.66)	22(11.34)	400.9	5.48
	35–44	97(87.39)	14(12.61)	227.7	6.14
	45^+	60(82.19)	13(6.25)	164.3	7.91
Occupation	Housewife	135(93.75)	9(17.60)	321.5	2.79
	Daily laborer	103(82.40)	22(17.60)	254	8.64
	Farmer	28(87.50)	4(12.5)	68.9	5.80
	Government employee	61(87.14)	9(12.86)	138.8	6.48
	Merchant	49(87.50)	7(12.50)	107.8	6.49
	Student	12(85.71)	2(14.29)	51.6	3.87
Educational status	No formal education	37(92.50)	3(7.50)	76.1	3.94
	Primary	152(80.42)	37(19.58)	387.9	9.53
	Secondary	137(95.13%)	7(4.87%)	347.8	2.01
	Tertiary	62(91.18)	6(8.82)	131.3	4.56
Marital status	Never married	90(90.00)	10(10.00)	211	4.73
	Married	156(92.31)	13(7.69)	408.5	3.18
	Separated	32(78.05)	9(21.95)	83.1	10.83
	Widowed	29(74.36)	10(25.64)	59.2	16.87
	Divorced	81(88.04)	11(11.96)	181.3	6.06
Religion	Orthodox	141(90.97)	14(9.03)	325.9	4.29
	Muslim	18(94.74)	1(5.26)	75.5	1.32
	Protestant	224(85.50)	38(14.50)	529.7	7.17
	Other**	5(100)	0	11.9	0
Residence	Urban	238(86.55)	37(13.45)	613.6	6.03
	Rural	90(90.36)	16(9.64)	329.6	4.85
Total		388(88.98%)	53(12.02%)	943.2	5.61

Note: **Catholic Adventist.

Abbreviation: PYO, Person year of observation.

Table 2 Baseline Clinical and Laboratory Characteristics of the Study Participants of Adult HIV/AIDS Patients Receiving ART at Wolaita Sodo Comprehensive Specialized Hospital, Southern Ethiopia, 2021

Variable	Category	Censored (N=388)	Death (N=53)	PYO	IDR/100
Baseline weight (kg)	<40	51(85.00)	9(15.00)	114.1	7.88
	40.1–50	95(80.15)	23(19.49)	219.4	10.48
	50.1–60	137(91.33)	13(8.67)	333.4	3.89
	>60	105(92.92)	8(7.08)	276.3	2.89
CD4 count (cells/μL)	≤200	163(80.69)	39(19.31)	404.3	9.64
	200–350	125(94.70)	7(5.30)	263.2	2.65
	>350	72(93.46)	7(6.54)	275.6	2.53
Functional status	Working	309(94.21)	19(5.79)	754.8	2.51
	Ambulatory	62(77.50)	18(22.50)	142	12.67
	Bedridden	17(51.52)	16(48.48)	46.3	34.53
WHO stage	I and II	267(90.02)	14(4.94)	655.7	2.13
	III and IV	121(75.63)	39(24.34)	287.5	13.56
Substance use	Yes	42 (60.00)	28(40.00)	109.2	25.64
	No	346(93.26)	25(6.74)	834	2.99
Alcohol use (n=70)	Yes	37(57.81)	27(42.19)	92.7	29.11
	No	5(83.33)	1(16.67)	16.4	6.09
Cigarette smoke (n=70)	Yes	3(75.00)	1(25.00)	4.6	2.18
	No	39(59.09)	27(40.00)	104.6	25.64
Chat use (n=70)	Yes	16(61.54)	10(38.46)	56.7	17.64
	No	25(59.09)	18(40.91)	52.5	34.28
Presence of Opportunistic infection	Yes	69(69.70)	30(30.30)	138	21.73
	No	319(93.27)	23(6.73)	705.2	2.85
Body mass index (BMI)	Under weight	211(85.77)	35(14.23)	495.92	7.05
	Normal	137(88.96)	17(11.04)	316.58	5.03
	Over weight	40(97.56)	1(2.44)	130.66	0.76
Disclosure status	Yes	309(89.31)	37(10.69)	719	5.14
	No	79(83.16)	16(16.84)	205	7.80
History of TB at start	Yes	59(73.75)	21(26.25)	103.6	20.27
	No	319(91.14)	32(8.86)	839.6	3.81
Drug regimen (*)	1a+1c+1d+1f	12(75.00)	4(25.00)	47.1	8.49
	1e	323(88.25)	43(9.75)	873	4.92
	1j	53(89.83)	6(10.17)	23.1	25.99
Drug adherence	Poor	15(51.72)	14(48.28)	49.8	28.09
	Fair	43(75.44)	14(24.56)	101.3	13.81
	Good	330(92.96)	25(7.04)	792	3.15
History of use of INH	Yes	279(91.78)	25(8.22)	650	3.84
	No	109(79.56)	28(20.44)	293.2	9.55
Hemoglobin level (gm/dL)	Severe anemia	4(57.14)	3(42.86)	6.5	46.15
	Moderate anemia	26(55.32)	21(44.68)	54.5	38.53
	Mild anemia	127(88.81)	16(11.19)	350.1	4.57
	No anemia	231(94.67)	13(5.33)	532.1	2.44
History of intravenous drug use	Yes	91(72.22)	35(27.78)	215.5	16.24
	No	297(94.29)	18(5.71)	727.7	2.47
Blood Creatinine level (Mg/dl)	Low	105(82.03)	23(17.97)	279.3	8.23
	Normal	254(90.39)	27(9.61)	590.2	4.57
	Raised	29(90.62)	3(9.38)	73.6	4.07
T-CD4 lymphocyte (CD4%)	≤25%	307(86.48)	48(13.52)	7739.2	6.66
	> 25%	81(94.18)	5(5.81)	204.0	2.48
Platelets count rate (per McL of blood)	<150,000	125(75.30)	41(24.70)	333.3	12.3
	150,000–450,000	216(95.58)	10(4.42)	500.5	1.99
	>450,000	47(95.92)	2(4.08)	109.3	1.82
Total		388(87.98%)	53(12.02%)	943.2	5.61

Notes: *(1a=D4T-3TC-NVP; 1c=AZT-3TC-NVP; 1d=AZT-3TC-EFV; 1e=TDF-3TC-EFV; 1f=TDF+3TC+NVP; 1j= TDF + 3TC+ DTG).

Abbreviations: PYO, Person Years Of Observation; IDR, Incidence Death Rate.

Figure 1 Overall survival probability of HIV/ADIS patients who started antiretroviral therapy at WSUCSH, Southern Ethiopia, 2021.

Figure 2 KM survival estimate for WHO stage among adult HIV patients receiving ART at WSUCSH, Southern Ethiopia, 2021.

Table 3 Baseline Characteristics and Probability of Survival During 6-Year of Follow-Up (Kaplan-Meier Method) of Adult HIV/AIDS Patients Receiving ART at Wolaita Sodo Comprehensive Specialized Hospital, Southern Ethiopia, 2021

Variables		Mean Survival Time in Months (95% CI)	Log-Rank,X^2	Log Rank P-value
Sex	Male	57.19 (52.89–61.49)	6.64	0.01
	Female	64.44 (61.80–67.07)
Residence	Urban	60.55(57.44–63.65)	1.42	0.232
	Rural	62.51(58.56–66.45)
Functional status	Working	66.44(64.45–68.43)	71.13	<0.001
	Ambulatory	52.17(44.67–59.68)
	Bedridden	28.16(19.81–36.22)
Substance use	Yes	36.91(28.93–44.89)	75.58	<0.001
	No	65.59(63.52–67.63)
WHO stage	I and II	67.03(65.00–69.05)	40.74	0.001
	III and IV	50.95(45.65–56.24)
Presence of OIs	Yes	44.80(37.25–52.35)	51.54	<0.0001
	No	65.64(63.53–67.74)
Presence of Tuberculosis	Yes	41.57(34.10–49.05)	28.27	<0.001
	No	64.14(61.88–66.40)
Drug adherence	Poor	35.39(23.00–47.78)	2.07	<0.001
	Fair	48.83(40.82–56.84)
	Good	65.22(63.04–67.40)
History of isoniazid use	Yes	64.29(61.75–66.80)	14.34	0.002
	No	55.02(49.84–60.20)
History of intravenous drug use	Yes	48.04(41.79–53.30)	48.22	<0.001
	No	66.35(64.27–68.43)

Figure 3 Nelson-Aalen cumulative hazard graph with Cox-Snell residual in adult ART patients at WSUCSH, Southern Ethiopia, 2021.

Table 4 Results of the Bivariate and Multivariate Cox Regression Analysis of HIV Patients Receiving Antiretroviral Treatment at Wolaita Sodo Comprehensive Specialized Hospital, Southern Ethiopia, 2021

Variables	Category	CHR (95% CI)	AHR (95% CI)	p-value
Sex	Male	1.00 (reference)	1.00 (reference)
	Female	0.48 (0.28 −0.83)	0.50 (0.22–1.14)	0.100
Marital status	Never married	1.00 (reference)	1.00 (reference)
	Married	0.67(0.30–1.50)	0.90(0.31–2.55)	0.847
	Separated	1.87(0.77–4.51)	0.98(0.27–3.53)	0.984
	Widowed	2.61(1.08–6.32)	10.9(3.13–37.99)	0.001
	Divorced	1.11(0.48–2.57)	2.54(0.81–7.91)	0.108
Drug adherence	Good	1.00 (reference)	1.00 (reference)
	Fair	4.03(2.09–7.75)	3.53(1.58–7.87)	0.002
	Poor	7.62(3.96–14.68)	5.6(2.4–13.28)	<0.001
Baseline CD4 count (cells/μL)	≤200	3.39(1.52–7.60)	1.08(0.39–3.02)	0.869
	200–350	0.95(0.33–2.72)	0.75(0.23–2.46)	0.724
	>350	1.00 (reference)	1.00 (reference)
WHO stage	I	1.00 (reference)	1.00 (reference)
	II	2.36(0.74–7.43)	1.86(0.49–7.05)	0.361
	III	6.94(2.62–18.43)	1.80(0.49–6.59)	0.371
	IV	22.83(8.5–60.95)	5.91(1.41–24.71)	0.015
Functional status	Working	1.00 (reference)	1.00 (reference)
	Ambulatory	4.81(2.5–9.17)	2.05(0.78–5.450)	0.143
	Bedridden	10.39(5.31–20.3)	1.06 (0.34–3.33)	0.910
Baseline BMI	Under weight	7.8(1.06–57.01)	2.96(0.37 −23.31)	0.301
	Normal	5.84(0.77–43.96)	3.76(0.45–31.25)	0.219
	Over weight	1.00 (reference)	1.00 (reference)
TB co-morbidity	Yes	4.0(2.29–6.98)	1.36(0.62–2.99)	0.432
	No	1.00 (reference)	1.00 (reference)
HIV disclosure status	Yes	1.00 (reference)	1.00 (reference)
	No	1.52(0.85–2.74)	0.60(0.27–1.34)	0.219
Substance use	Yes	7.59(4.41–13.05)	2.02(1.01–4.06)	0.047
	No	1.00 (reference)	1.00 (reference)
History of use INH	Yes	1.00 (reference)	1.00 (reference)
	No	2.7(1.57–4.63)	0.80(0.41–1.53)	0.503
History of IV drug use	Yes	5.85(3.31–10.34)	2.26(1.08–4.74)	0.03
	No	1.00 (reference)	1.00 (reference)
Presence of OIs	Yes	5.83(3.37–10.08)	0.93(0.40–2.15)	0.883
	No	1.00 (reference)	1.00 (reference)
Anemia	No anemia	1.00 (reference)	1.00 (reference)
	Mild anemia	1.95(0.93–4.06)	0.46(0.18–1.88)	0.110
	Moderate anemia	11.4(5.69–22.97)	1.62(0.59–4.44)	0.346
	Severe anemia	13.1(3.71–46.25)	1.02(0.18–5.61)	0.974
Platelets count rates (per McL of blood)	<150,000	6.42(1.55–26.56)	2.37(0.52–10.97)	0.259
	150,000–450,000	1.14(0.24–5.20)	0.57 (0.10–3.02)	0.510
	>450,000	1.00 (reference)	1.00 (reference)
Creatinine level (Mg/dl)	Low	1.00 (reference)	1.00 (reference)
	Normal	0.55(0.31–0.95)	0.51(0.25–1.02)	0.06
	Raised	0.51(0.15–1.72)	0.47(0.10–2.23)	0.344

Note: Statistical Significance was declared at p-value<0.05 and in bold.

Abbreviations: CHR, crude hazard ratio; CI, confidence interval; AHR, adjusted hazard ratio; WHO, World Health Organization; IV, intravenous.