Statistical Modeling of Survival of Tuberculosis Infected HIV Patients Treated with Antiretroviral Treatment: A Case of Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

Abstract

Objectives: This study focused on modeling of the survival of tuberculosis infected HIV patients treated with antiretroviral treatment in Felege Hiwot referral hospital. Methods: Human Immunodeficiency Virus/tuberculosis (HIV/TB) co-infected patients aged 15 years and above were selected using simple random sampling and included in the study. The sample size for this study was 314 patients. Kaplan-Meier survival curves and Log-Rank test were used to compare the survival experience of different category of patients, and proportional hazards Cox proportional hazards model was employed to identify independent predictors of survival of HIV/TB patients. Results: Of the total samples 66 (21.0%) were died and 248 (79.0%) were censored. The results of single covariate analysis show that the variables: sex, age, marital status, literacy status, employment status, family size number of living rooms, CD4 count, baseline body weight, WHO stage, regimen type, knowledge about ART, condom use, drug use, alcohol intake, tuberclosis category and regimen change were found to be factors that significantly influence the survival of HIV/TB co-infected patients at 25% significance level. From the Cox regression analysis, the independent factors CD4 count, tuberculosis category, number of living rooms, employment status, alcohol and tobacco use were significant. The odds of being at risk of death for patients who does not smoke tobacco is 47.5% less than those who use tobacco. Conclusions: In conclusion, baseline CD4 count, tuberculosis category, number of living rooms, employment status, alcohol and tobacco use were the main factors significantly influencing the survival time of HIV/TB co-infected patients. We recommend that, there should be a careful monitoring of patients with low CD4 count, less than two numbers of rooms, disseminated and extra-pulmonary TB, having risk behaviors like drinking alcohol and not being employed is necessary to improve survival of HIV/TB co-infected patients.