Life expectancy of HIV-positive patients after diagnosis in Iran from 1986 to 2016: A retrospective cohort study at national and sub-national levels

Mirzaei, Mohammad; Farhadian, Maryam; Poorolajal, Jalal; Kazerooni, Parvin Afasr; Tayeri, Katayoun; Mohammadi, Younes

doi:10.4178/epih.e2018053

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Yaghoobi et al showed that life expectancy in HIV-positive patients in Iran was very low compared to the general population [23]. In another study, life expectancy in HIV-positive patients in Iran was reported low [24]. The low quality of medical care services for HIV patients in Iran, especially inadequate coverage of ART program, can explain the observed differences between our findings and those reported from other countries [14].…”

Section: Discussioncontrasting

confidence: 74%

Factors associated with progression from HIV to death in patients receiving antiretroviral therapy in Southern Iran: a 21-year survival analysis and follow-up study

Afrashteh,

Fararouei,

Ghaem

et al. 2023

HIV & AIDS Review

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Introduction:The expansion of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic has been considered a serious issue globally, and the disease is currently a major contributing factor to morbidity and mortality rates in many developing countries. This study aimed to investigate survival rate of HIV-positive patients, and its' contributing factors among individuals receiving antiretroviral therapy in Southern Iran. Material and methods:A prospective cohort study was conducted among 1,327 HIV patients, who started antiretroviral therapy (ART) between June 2000 and March 2021. Kaplan-Meier analysis and Cox proportional hazard regression analyses were applied to define the survival rate of patients. Results:In this study, of 1,327 registered HIV/AIDS patients who were under ART, 30.6% died during the study period. The 1-, 2-, 5-, and 10-year survival rates of the patients were 90%, 87%, 78%, and 67%, respectively. Based on the results of multivariate Cox regression analysis, older age (HR ≥40/<40 = 1.48), occupation (HR unemployment/employment = 1.29), history of addiction (OR yes/no = 1.64), route of transmission (HR IDU/sexual = 0.48), baseline CD4+ < 200 (HR < 200/> 500 = 2.91), clinical stage IV (HR IV/I = 1.70), ART adherence (HR adherence/non-adherence = 0.37), time on ART > 5 (HR > 5/< 1 = 0.06), and anemia (HR yes/no = 1.58) were directly associated with the survival in patients. Conclusions:Mortality in adults HIV-positive patients on antiretroviral therapy is relatively high in Iran. Age, history addiction, WHO clinical stage, low CD4+ count, and anemia are associated with poor survival in HIV patients. Concerned stakeholders should focus on early detection, timely ART onset, and adherence to treatment.

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Section: Discussioncontrasting

confidence: 74%

Factors associated with progression from HIV to death in patients receiving antiretroviral therapy in Southern Iran: a 21-year survival analysis and follow-up study

Afrashteh,

Fararouei,

Ghaem

et al. 2023

HIV & AIDS Review

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“…Moreover, evaluation of life expectancy in HIV-positive patients in Iran showed a little difference among provinces. The difference between the highest and lowest life expectancy was 18 years [28], which is consistent with the difference in human development index among provinces [29]. There-fore, differences in survival among provinces of Iran, and between Iran and other countries can be explained.…”

Section: Discussionsupporting

confidence: 72%

Evaluation of factors affecting survival of HIV/AIDS patients using Cox and extended Cox models

Pakdin¹,

Rezaeian²,

Najafi³

et al. 2022

HIV & AIDS Review

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Introduction: Acquired immune deficiency syndrome (AIDS) is a global viral disease that is increasing in populations with high-risk behaviors. Identifying factors prolonging survival of human immunodeficiency virus (HIV)-positive patients is imperative, and retrospective cohort studies with survival analysis approach are most applicable in research. The present study aims to determine an assessment of survival of HIV/AIDS-positive patients and its' related factors. Material and methods:The present retrospective cohort study was conducted based on medical records of HIV-positive patients visiting Behavioral Diseases Counseling Centers in Kermanshah during 1996-2018. Cox and extended Cox regression models were applied for univariate and multivariate analyses. Data were analyzed using STATA-14. Results:The likelihood of one-, five-, and ten-year survival from the time of HIV diagnosis until AIDS stage was found as 0.87, 0.69, and 0.54, respectively, and the likelihood of one-, five-, and tenyear survival until AIDS-related death was estimated as 0.75, 0.44, and 0.21, respectively. The risk of disease progression to AIDS was greater in women and in patients with tuberculosis comorbidity. Receiving antiretroviral therapy reduced the risk of AIDS-related death by 3.9 times. Conclusions:The main correctable factors affecting the survival of HIV/AIDS patients include early diagnosis, adherence to treatment, and receiving periodic services.

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“…Based on the findings of this study, the participants indicated that an HIV-positive diagnosis meant an imminent death sentence. Although recent advances in the ART can prolong life by suppressing viral activities and HIV is now identified as a controllable chronic illness, there is still no known HIV/AIDS cure and the life expectancy of PLWH is low [48]. Accordingly, the disease is perceived as a “social and physical death” [11] in society.…”

Section: Discussionmentioning

confidence: 99%

Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS: A qualitative study

Barkish

Jalali

2019

Heliyon

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Background A diagnosis of HIV (human immunodeficiency virus) infection causes a wide range of mental challenges regarding the meaning and understanding of such a diagnosis because of the specific nature of HIV and its social consequences. AIDS patients perceived their disease as multidimensional Stigma and rejection and even discrimination and insult in receiving health services. Therefore, a deep awareness and understanding of an individual's meaning and interpretation of a HIV-positive diagnosis and their relevant experiences are essential for providing better care. Objective This study aimed to examine the attitude, understanding, and interpretation of a positive diagnosis of HIV. Methods The present qualitative study was based on the descriptive phenomenological method. Participants included 13 HIV-positive patients who had been referred to the Kermanshah Counseling Center for Behavioral Diseases in Iran and diagnosed at most 6 months before being interviewed. The data were collected via semi-structured in-depth interviews. Results The continuous analyses of the data and the interview notes resulted in the identification of five main themes: contagious disease with two subthemes Illness and Harm to others, new self with a Crisis of identity subtheme, disappointment with the life ending and impending death subtheme, unmentionable disease with two subthemes secretive and horrifying diseases, and loss with Frustration subtheme. Conclusion Because the attitudes and behaviors of other people, such as relatives and people in society had a negative impact on the participants' mental status, as well as on their perceptions and understanding about the positive diagnosis, the focus of care for people with HIV/AIDS should shift from therapeutic issues to socio-cultural ones. These issues play a major role in forming an individual's understanding of HIV and can be a vital factor in improving their activities and adaptations to a positive diagnosis.

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Life expectancy of HIV-positive patients after diagnosis in Iran from 1986 to 2016: A retrospective cohort study at national and sub-national levels

Cited by 4 publications

References 17 publications

Factors associated with progression from HIV to death in patients receiving antiretroviral therapy in Southern Iran: a 21-year survival analysis and follow-up study

Factors associated with progression from HIV to death in patients receiving antiretroviral therapy in Southern Iran: a 21-year survival analysis and follow-up study

Evaluation of factors affecting survival of HIV/AIDS patients using Cox and extended Cox models

Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS: A qualitative study

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