Year : 2021 | Volume
: 9 | Issue : 2 | Page : 135--144
Survival and prognostic factors of HIV-positive patients after antiretroviral therapy initiation at a Malaysian referral hospital
Lee Sing Chet1, Siti Azrin Ab Hamid1, Norsa'adah Bachok1, Suresh Kumar Chidambaram2, Wan Nor Asyikeen Wan Adnan1
1 Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Sungai Buloh, Selangor, Malaysia
2 Department of General Medicine, Infectious Disease Unit, Sungai Buloh Hospital, Sungai Buloh, Selangor, Malaysia
Background: Antiretroviral therapy (ART) has transformed the management of human immunodeficiency virus (HIV) infection and significantly improved survival rates, but there is lack of such survival data from Malaysia.
Objective: The objective was to determine the survival rates and prognostic factors of survival in HIV-infected adults treated with ART in Malaysia.
Materials and Methods: This retrospective cohort study considered all HIV-positive adult patients registered in Sungai Buloh Hospital, a major referral center in Malaysia, between January 1, 2007 and December 31, 2016. Then, patients were selected through a systematic sampling method. Demographic, clinical, and treatment data were extracted from electronic medical records. Person–years at risk and incidence of mortality rate per 100 person–years were calculated. The Kaplan–Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.
Results: A total of 339 patients were included. The estimated overall survival rates were 93.8%, 90.4%, 84.9%, and 72.8% at 1, 3, 5, and 10 years, respectively, from ART initiation. The results of multiple Cox proportional hazard regression indicated that anemic patients were at a 3.76 times higher risk of mortality (95% confidence interval [CI]: 1.97–7.18; P < 0.001). The hazard risk was 2.09 times higher for HIV patients co-infected with tuberculosis (95% CI: 1.10, 3.96; P = 0.024).
Conclusion: The overall survival rates among HIV-infected adults in this study are higher than that from low-income countries but lower than that from high-income countries. Low baseline hemoglobin levels of <11 g/dL and tuberculosis co-infection were strong prognostic factors for survival.
Siti Azrin Ab Hamid
Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
|How to cite this article:|
Chet LS, Hamid SA, Bachok N, Chidambaram SK, Adnan WN. Survival and prognostic factors of HIV-positive patients after antiretroviral therapy initiation at a Malaysian referral hospital.Saudi J Med Med Sci 2021;9:135-144
|How to cite this URL:|
Chet LS, Hamid SA, Bachok N, Chidambaram SK, Adnan WN. Survival and prognostic factors of HIV-positive patients after antiretroviral therapy initiation at a Malaysian referral hospital. Saudi J Med Med Sci [serial online] 2021 [cited 2021 Jun 23 ];9:135-144
Available from: https://www.sjmms.net/article.asp?issn=1658-631X;year=2021;volume=9;issue=2;spage=135;epage=144;aulast=Chet;type=0