Risk Factors for Mortality among HIV/AIDS Patients

Abstract

Background: Morbidity and mortality of HIV/AIDS infections is still high and as a global health problem particularly in Low-Middle Income Countries (LMICs). Indonesia ranks third in Asia Pacific in increasing HIV infection. A Study on risk factors for mortality in HIV/AIDS patients in Dr. Kariadi General Hospital has never been conducted. This study analyzed the risk factors for mortality among HIV/AIDS patients.Methods: Case control study, data from medical records of inpatients and outpatients in Dr. Kariadi General Hospital from January 2015 to December 2017.Results: Study subject: Two hundred and ten HIV/AIDS patients, were included; 105 (56.75%) as cases and 105 (9.65%) control patients. The significant risk factors for mortality were as follow: male sex (p = 0.030); age ≥ 45 years (p = 0.035); non compliance to treatment (p = 0,000); WHO clinical stage III and IV (p = 0,000); co-infection of pulmonary tuberculosis (p = 0,000); CD4 cell count < 200 cells/mm3 (p = 0,000); eGFR < 60 mL/minute/1.72 m2 (p = 0.001) and Haemoglobin level < 10 g/dL (p = 0.008). The non-significant risk factors for mortality were as follow: level of education (p = 0.650); Hepatitis B co-infection (p = 0.153) and Hepatitis C co-infection (p = 0.506). The most important risk factors for mortality in this study in were non compliance to treatment (p = 0.003; OR = 3.285) and CD4 count < 200 cells/mm3 (p = 0.014; OR = 5.480).Conclusion: In this study, the risk factors for mortality in HIV/AIDS patients were male sex; age ≥ 45 years; non compliance to treatment; WHO clinical stage III and IV; co-infection of pulmonary tuberculosis, CD4 count < 200 cells/mm3; eGFR < 60 mL/minute/1.72 m2 and Hb level < 10 g/dL. The most important risk factors for mortality were non compliance to treatment and CD4 count < 200 cells / mm3.

Survival analysis and predictors of mortality for adult HIV/AIDS patients following antiretroviral therapy in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: a retrospective cohort study

“…Previous studies reported that patient's age was found to be predictor of mortality, where most of patients in older age were more likely to die [18,21,24]. Our study also revealed similar outcome.…”

“…Majority of previous studies in Ethiopia also found twice or more risk of mortality for patients with lower CD4 count compared to those with a CD4 count of > 350 cells/ml [11,15,[19][20][21][22][23]. Studies performed across many parts of Africa and Asia reported that low level of CD4 count at baseline was associated with high level of mortality among patients on ART [16,18,24,25].…”

The Occurrence of Tuberculosis Infection among Newly HIV Diagnosed Patient in Indonesia

“…In 2017, 420.994 instances of TB were reported, with 1.85% of them infected with HIV [7]. TB is the second most common opportunistic illness in Indonesia, and it is also the leading cause of death among HIV patients [8]. Early detection of TB infection in HIV patients, on the other hand, can aid with efficient treatment and thereby reduce the mortality rate in HIV patients due to co-infection with TB.…”

Splenectomy for Aseptic Splenic Abscess

“…It is usually trauma, embolization or hemoglobinopathy consequence (Mustafa et al 2015). Immunodeficiency is HIV virus risk factor impact (Haider et al 2019, Kusumaadhi et al 2021. Splenic abscess is a rare case.…”