Clinical outcome of hospitalized HIV/AIDS patients in selected Ethiopian tertiary care settings: A prospective cohort study

Getandale Zeleke(B.pharm,Msc), Teshale Ayele(B.pharm,Msc), Admasu Tena (MD,internist)

Abstract

Background: Evidences from developed countries showed that non- Acquired ImmunoDeficiency Syndrome (AIDS) related illnesses are becoming the leading cause of death among hospitalized Human Immune virus (HIV)/ AIDS patients. However; there is limited evidence regarding this outcome among HIV infected patients admitted to hospitals in low-income countries like Ethiopia.

Objective: To determine clinical outcome of admitted HIV/AIDS patients in selected Ethiopian tertiary care settings.

Methods: A prospective cohort study was conducted among admitted HIV/AIDS patients from April 1 to August 31, 2018 in Jimma University Medical Center (JUMC) and Tikur Anbessa Specialized Hospital (TASH). Data of 136 patients was collected on socio-demographic, clinical characteristics and drug related variables. Data was entered into EpiData version 3.1 and analyzed using SPSS version 21. Study participants were categorized into two groups, as AIDS and non-AIDS related admissions. Kaplan-Meier and Cox regression was used to compare survival experience of the patients and identify independent predictors of mortality. Hazard ratio was used as measure strength of association and p-value of <0.05 was considered to declare statistical significance.

Results: Of 136 patients, 80 (58.8%) were females. The overall in-hospital mortality was 39(28.7%). In-hospital death rates were 30.3% and 27.1% for AIDS (66 patients) and non-AIDS (70 patients) related admissions, respectively (p=0.68). The median survival time among patients with non-AIDS related admissions was 35[53, 23] days and 32 days for AIDS-related admissions (log rank p=0.599).

The need of non-invasive ventilation (AHR: 2.99, 95%CI; [1.24, 7.28]; p=0.015) and body mass index (BMI) of less than 18.5(AHR: 2.6, 95%CI; [1.03, 6.45]; p=0.04) were independent predictors of mortality.

Conclusion: Similar to studies conducted in low-income countries, AIDS-related illnesses remain the leading cause of death. The need of non-invasive ventilation and low body mass index (BMI) were found to be independent predictors of mortality.

Key-words: clinical outcome, Human immune virus, Acquired immunodeficiency syndrome, Jimma University Medical Center, Tikur Anbessa Specialized Hospital