Revista de SIDA e investigación clínica

Time to Recurrence of any Opportunistic Infection after Treatment of it among People Living with HIV Infection in Debre Markos, Northwest Ethiopia: Retrospective Cohort Study

Abstract

Habtamu Mellie, Getnet Mitike and Amanuel Alemu Abajobir

Introduction: Antiretroviral therapy improves time to death of people living with HIV; however, little is known about its effect on improving time of recurrence of opportunistic infections after treatment of any preceding infection. Hence, this study was aimed at assessing time to recurrence of any opportunistic infection after treatment of any preceding opportunistic infection, its magnitude and associated factors.

Methods: Retrospective cohort study was used and the required sample size was 536. Study participants were selected randomly from the list of adult people living with HIV attending the public health facilities for ART. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Kaplan-meier survival and log rank test were used to estimate survival and compare survival curves respectively. Cox proportional-hazard regression model was used to calculate hazard rate and to determine independent predictors of time to recurrence.

Results: During a median of 43 person weeks follow up, opportunistic infections recurred in 75.7% the participants and the proportion was not significantly different (p=0.614) in pre-ART and ART people living with HIV. The incidence rate of any opportunistic infection recurrence was 1.31 per 100 person weeks which differs by ART exposure status which was 1.57 and 1.13 per 100 person weeks in pre-ART and ART PLHIV respectively. The median time of survival was 57 weeks; however, it was different in pre-ART and ART PLHIV that was 52 and 64 weeks respectively. Marital status, occupational status, follow up CD4 count, base line hemoglobin value, ART exposure, base line ART adherence, base line and follow up prophylaxis exposure and adherence were predictors of survival.

Conclusion: The incidence rate of any opportunistic infection recurrence was 1.31 per 100 person weeks. Attention should be given for widowed, ART/prophylaxis non-adhering patients while continuing HIV care for all people living with the virus.