PIN14 - BIOMEDICAL AND THERAPEUTIC PREDICTORS OF SURVIVAL TIME AND MORTALITY OF ADULT HIV/TB CO-INFECTIONS; A RETROSPECTIVE COHORT STUDY

Abstract

Comprehensive assessment of biomedical and therapeutic predictors of survival time (ST) and mortality of TB/HIV co-infected patients. A retrospective cohort study design was used to review data of 364 confirmed TB/HIV patients from standard ART and TB registry, Ministry of Defense Teaching Hospital, Ethiopia. Patient mean age was 36.7 years. These TB/ HIV cases, other co-morbidities ruled out, were treated between 2014 –2016. For the survival analysis, the outcome of interest was ‘treatment failure’ or ‘death’. A univariate descriptive statistical analysis was performed using a non- parametric procedure, Kaplan -Meier (KM) method to estimate overall survival (OS) time, while Cox proportional hazard model was used in multivariate Cox regression analysis to determine a possible association of predictor variables and to obtain adjusted hazard ratios. P-value was set at, 0.05, log likelihood ratio test at 0.10. Data were analyzed using SPSS version 18.0. There was no significant difference in the survival curves of male and female patients (Log rank statistic =0.005, d f=1, p=0.945) and among different age group (Log rank statistic =28.622, d f=40, p=0.910). The mean overall survival (OS) time was 24.8 months (95%CI: 18–31). The mean ST for women was 29.8 months (95%CI: 76.6–694) while for men was 17.9 months (95%CI: 13.5–22.2). Survival time varies by CD4 cell count, WHO clinical stage; functional status, TB Rx regimen, TB Rx Phase and type of HAART and multivariate Cox regression showed that these factors were also important predictors of mortality. Biomedical and therapeutic monitoring of HIV/TB co-infected patients with low CD4 cell count, advanced WHO stages III & IV, ambulatory and bedridden functional status, diagnosed TB site, TB treatment Phase and HAART regimen is necessary to improve survival and reduce the risk of death of patients at initiation, during anti-TB treatment and ART follow up period.