Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study
Background. Study examined the determinants of mortality among adult HIV patients in a rural, tertiary hospital in southeastern Nigeria, comparing mortality among various ART regimens. Methods. Retrospective cohort study of 1069 patients on ART between August 2008 and October 2013. Baseline CD4 coun...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2014/867827 |
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| author | Kelechi N. Eguzo Adegboyega K. Lawal Cynthia E. Eseigbe Chisara C. Umezurike |
| author_facet | Kelechi N. Eguzo Adegboyega K. Lawal Cynthia E. Eseigbe Chisara C. Umezurike |
| author_sort | Kelechi N. Eguzo |
| collection | DOAJ |
| description | Background. Study examined the determinants of mortality among adult HIV patients in a rural, tertiary hospital in southeastern Nigeria, comparing mortality among various ART regimens. Methods. Retrospective cohort study of 1069 patients on ART between August 2008 and October 2013. Baseline CD4 counts, age, gender, and ART regimen were considered in this study. Kaplan-Meier method was used to estimate survival and Cox proportional hazards models to identify multivariate predictors of mortality. Median follow-up period was 24 months (IQR 6–45). Results. 78 (7.3%) patients died with 15.6% lost to followup. Significant independent predictors of mortality include age (>45), sex (male > female), baseline CD4 stage (<200), and ART combination. Adjusted mortality hazard was 3 times higher among patients with CD4 count <200 cells/μL than those with counts >500 (95% CI 1.69–13.59). Patients on Truvada-based first-line regimens were 88% more likely to die than those on Combivir-based first line (95% CI 1.05–3.36), especially those with CD4 count <200 cells/μL. Conclusion. Study showed lower mortality than most studies in Nigeria and Africa, with mortality higher among males and patients with CD4 count <200. Further studies are recommended to further compare treatment outcomes between Combivir- and Truvada-based regimens in resource-limited settings using clinical indicators. |
| format | Article |
| id | doaj-art-fc6d1fbe6c524986a4ce4c18b8c9311c |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj-art-fc6d1fbe6c524986a4ce4c18b8c9311c2025-02-03T05:46:42ZengWileyAIDS Research and Treatment2090-12402090-12592014-01-01201410.1155/2014/867827867827Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort StudyKelechi N. Eguzo0Adegboyega K. Lawal1Cynthia E. Eseigbe2Chisara C. Umezurike3School of Public Health, University of Saskatchewan, Saskatoon, SK, S7N 5E5, CanadaSchool of Public Health, University of Saskatchewan, Saskatoon, SK, S7N 5E5, CanadaDepartment of Laboratory Services, Nigerian Christian Hospital, Aba, Abia State 450001, NigeriaDepartment of Obstetrics and Gynecology, Nigerian Christian Hospital, Aba, Abia State 450001, NigeriaBackground. Study examined the determinants of mortality among adult HIV patients in a rural, tertiary hospital in southeastern Nigeria, comparing mortality among various ART regimens. Methods. Retrospective cohort study of 1069 patients on ART between August 2008 and October 2013. Baseline CD4 counts, age, gender, and ART regimen were considered in this study. Kaplan-Meier method was used to estimate survival and Cox proportional hazards models to identify multivariate predictors of mortality. Median follow-up period was 24 months (IQR 6–45). Results. 78 (7.3%) patients died with 15.6% lost to followup. Significant independent predictors of mortality include age (>45), sex (male > female), baseline CD4 stage (<200), and ART combination. Adjusted mortality hazard was 3 times higher among patients with CD4 count <200 cells/μL than those with counts >500 (95% CI 1.69–13.59). Patients on Truvada-based first-line regimens were 88% more likely to die than those on Combivir-based first line (95% CI 1.05–3.36), especially those with CD4 count <200 cells/μL. Conclusion. Study showed lower mortality than most studies in Nigeria and Africa, with mortality higher among males and patients with CD4 count <200. Further studies are recommended to further compare treatment outcomes between Combivir- and Truvada-based regimens in resource-limited settings using clinical indicators.http://dx.doi.org/10.1155/2014/867827 |
| spellingShingle | Kelechi N. Eguzo Adegboyega K. Lawal Cynthia E. Eseigbe Chisara C. Umezurike Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study AIDS Research and Treatment |
| title | Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study |
| title_full | Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study |
| title_fullStr | Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study |
| title_full_unstemmed | Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study |
| title_short | Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study |
| title_sort | determinants of mortality among adult hiv infected patients on antiretroviral therapy in a rural hospital in southeastern nigeria a 5 year cohort study |
| url | http://dx.doi.org/10.1155/2014/867827 |
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