Mortality and its predictors among highly active antiretroviral therapy naive hiv-infected individuals: data from prospective cohort study in Ukraine

Georgian Med News. 2014 Jul-Aug:(232-233):69-74.

Abstract

There is little information from Ukraine about the effect of Highly active antiretroviral therapy (HAART) on survival of HIV-infected patients. Our objective was to identify predictors of mortality in HIV-infected patients initiating HAART at the Zaporizhzhya AIDS Center, Ukraine. Prospective cohort study of HIV-infected patients from January 2005 to December 2008 in a Zaporizhzhya AIDS Center, and were tracked for 60 months after start HAART. Unvaried and multivariate analysis and constructed Kaplan-Meier curves to assess predictors. To identify predictors of mortality were used to build a regression Cox proportional hazards model.Two hundred and seventy two patients were studied (mean age 34 years, 42% female, median CD4 count 120 cell/μL). In 60 months of HAART 36 patients died. The probability of survival was 87%. In the univariate analysis, mortality was strongly associated with male gender (HR 6,28; 95% CI 2,22-17,78), IDU route of HIV transmission (HR 2,90; 95% CI 1,32-6,36), WHO clinical stage 4 (HR 3,45 95% CI 1,7-7,0). Mortality was also strongly associated with anemia (HR 2,24 95% CI 1,02-4,92) and HBsAg seropositivity (HR 6,26 95% CI 3,01-13,02). In the multivariate analysis independent factors associated with mortality were WHO clinical stage 4 (HR 2,66 95% CI 1,26-5,58) and HBsAg seropositivity (HR 4,35 95% CI 2,05-9,23).

Conclusions: HAART significantly increased probability of survival and reduced the risk of death for HIV-infected patients in Ukraine. Simple clinical and laboratory data independently predict mortality and allow for risk stratification in HIV-infected patients in Ukraine.

MeSH terms

  • Adult
  • Anemia / etiology
  • Anemia / mortality
  • Antiretroviral Therapy, Highly Active*
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / mortality*
  • HIV Infections / transmission
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Survival Analysis
  • Ukraine / epidemiology
  • Young Adult