Statistical Joint Modeling on Longitudinal Body Weight and CD4 Cell Progression with Survival Time-to-Death Predictors on HIV/AIDS Patients in Mekelle General Hospital, Ethiopia.

Abstract

Background This study assessed the impact of repeated biomarker measurements of statistical joint modeling on survival time-to-death and determines potential predictors of HIV/AIDS patients on ART in Mekelle General Hospital Ethiopia. Methods A retrospective cohort study was conducted among HIV/AIDS patients who were under ART follow-up during September 11, 2013 - September 5, 2016 at Mekelle General Hospital, Ethiopia. The two repeated biomarkers of longitudinal measurements and survival outcome with separate univaraite longitudinal modeling approach and statistical joint modeling approach were used to fit simultaneously. A total of 216 HIV/AIDS patients were selected by using systematic random sampling technique from ART follow-up. Results The relationship between the two biomarkers CD4 cell and body weight with risk for survival time-to-death were statistical insignificant. Thus, death is less probable to occur in HIV/AIDS patients with higher value of CD4 cell count and body weight progression. In event process the sub-model, Baseline CD4, Fair and Good Adherence, HIV/TB (yes) and Sex (male) were significant factors of risk to short survival Time-to-Death on HIV/AIDS patients. In the 1st longitudinal process sub-model, Baseline CD4, Ambulatory functional status, HIV/TB (yes), Time*Ambulatory functional status, Time*Working functional status and Time*Baseline CD4 were the significant factors of \sqrt{CD4 cell } count progression. Moreover, In 2nd longitudinal process sub-model, visit Time of follow-up, Age, Sex (male), Baseline weight, Time*Ambulatory and Time*Working functional status were the significant factors of log 10(body weight) progression. Conclusion Both governmental and non-governmental stakeholders should pay special attention for HIV positive adults, especially for those who had developed HIV/TB, male, bedridden functional status, poor adherence and lower Baseline CD4 cell count progression so that mortality due to HIV/AIDS optimally reduced.