Determinants of Survival in Adult HIV Clients on Antiretroviral Therapy in Lawra and Jirapa Districts of Upper West Region, Ghana

Abstract

We describe the rate of death and identify the determinants of survival in a cohort of adults starting antiretroviral therapy (ART) in 2 hospitals in Upper West Region, Ghana. Kaplan-Meier model was used to estimate the survival probability after ART initiation and Cox proportional hazard model used to assess the relationship between baseline variables and mortality. A total of 91 clients who were initiated on ART in both hospitals participated in the study. Clients staged in the World Health Organization (WHO) clinical stage III/IV had a higher risk of mortality than those staging I/II (hazard ratio [HR] of 3.93). Hemoglobin value at baseline with a cutoff ≥12 g/dL for women (and ≥13 for men) was strongly associated with mortality in participants with an HR of 3.87 (95% confidence interval [CI]: 0.71-21.19) for severe anemia, 2.11 (95% CI: 0.45-9.93) for moderate anemia, and 0.88 (95% CI: 0.16-4.82) for mild anemia. Anemia and WHO staging were independent predictors of mortality.