Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment

Riyaz Ahamed Shaik; Sharan K Holyachi; Mohammad S Ahmad; Mohammed Miraj; Mansour Alzahrani; Ritu Kumar Ahmad; Bader A Almehmadi; Mohammed Zaid Aljulifi; Meshari A Alzahrani; Mashael B Alharbi; Mohammed Muzammil Ahmed

doi:10.3389/fpubh.2023.1084210

Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment

Front Public Health. 2023 Mar 30:11:1084210. doi: 10.3389/fpubh.2023.1084210. eCollection 2023.

Affiliations

¹ Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia.
² Department of Community Medicine, Koppal Institute of Medical Sciences, Koppal, Karnataka, India.
³ Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia.
⁴ Department of Physiotherapy, College of Applied Medical Science, Buraydah Private Colleges, Buraydah, Saudi Arabia.
⁵ Department of Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia.
⁶ Department of Urology, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia.
⁷ Ministry of Health, Riyadh, Saudi Arabia.
⁸ Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia.

Abstract

Objective: To assess the demographic, clinical, and survival profile of people living with HIV.

Methods: A retrospective cohort study was conducted among patients enrolled at a single antiretroviral therapy center in North Karnataka. A total of 11,099 were recruited from April 2007 to January 2020, out of which 3,676 were excluded and the final 7,423 entries were subjected to analysis. The outcome of interest was the time to death in months of people living with HIV on antiretroviral therapy (ART). The clinical and demographic characteristics were examined as potential risk factors for survival analysis. To investigate the factors that influence the mortality of patients using ART, univariate and multivariate Cox regression were performed. Hazard ratio (HR), 95% confidence interval (CI), and p-values were presented to show the significance. The log-rank test was used to determine the significance of the Kaplan-Meier survival curve.

Results: Out of 7,423 HIV-positive people, majority were female (51.4%), heterosexual typology (89.2%), and in the age group 31-45 years (45.5%). The risk of death in male patients was 1.24 times higher (95% CI: 1.14-1.35) than female patients. Patients with age >45 were 1.67 times more likely to die than patients ≤30 (95% CI: 1.50-1.91). In the multivariable analysis, the hazards of mortality increased by 3.11 times (95% CI: 2.09-2.79) in patients with baseline CD4 count ≤50 as compared to those who had baseline CD4 count >200. The risk of death in patients who were diagnosed with TB was 1.30 times more (95% CI: 1.19-1.42) than in those who did not have TB. The survival probabilities at 3 and 90 months were more in female patients (93%, 70%) compared with male patients (89, 54%), respectively.

Conclusion: This study proved that age, sex, baseline CD4 count, and tuberculosis (TB) status act as risk factors for mortality among people with HIV. Prevention strategies, control measures, and program planning should be done based on the sociodemographic determinants of mortality.

Keywords: ART; CD4 counts; HIV; retroviral agents; risk factors; tuberculosis.

Publication types

Research Support, Non-U.S. Gov't
Retracted Publication

MeSH terms

Adult
Anti-Retroviral Agents / therapeutic use
Demography
Female
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Humans
India
Male
Middle Aged
Retrospective Studies
Risk Factors
Tuberculosis*

Substances

Anti-Retroviral Agents

Grants and funding

The authors extend their appreciation to the Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia, for funding this research work through the project number (IFP-2022-16).