Predictors of Mortality in HIV Patients Starting Treatment in Tanzania
Author Information
Author(s): Johannessen Asgeir, Naman Ezra, Ngowi Bernard J, Sandvik Leiv, Matee Mecky I, Aglen Henry E, Gundersen Svein G, Bruun Johan N
Primary Institution: Ulleval University Hospital, Oslo, Norway
Hypothesis
What factors predict mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania?
Conclusion
High mortality was observed among HIV patients starting ART, particularly within the first three months, with anemia, thrombocytopenia, and severe malnutrition identified as strong predictors of mortality.
Supporting Evidence
- 95 patients died during the follow-up period, with 59 dying within 3 months of starting ART.
- Estimated mortality was 19.2% at 3 months and 40.7% at 36 months.
- Severe anemia was associated with a 15 times higher risk of death compared to normal hemoglobin levels.
Takeaway
This study found that many people with HIV who start treatment in Tanzania die quickly, especially if they have low blood counts or are very underweight.
Methodology
A cohort study of treatment-naïve adults starting ART, using Kaplan-Meier and Cox proportional hazards models to analyze mortality predictors.
Potential Biases
Selection bias may exist as the study was conducted in a hospital setting, potentially favoring patients with more severe disease.
Limitations
Mortality may be underestimated due to patients lost to follow-up, and the study's setting may not represent all HIV patients.
Participant Demographics
The cohort included 320 treatment-naïve adults, predominantly women (69.7%), with a median age of 35 years.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 2.05–41.3 for severe anemia
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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