Background and purposeHIV disease is one of the major public health challenges and its early diagnosis and timely management play a vital role in reducing mortality. This study examines factors affecting the mortality of HIV patients and the effect of delay in diagnosis on survival.MethodsIn this retrospective cohort study, data from the ART Center of Koppal District Hospital, India, from April 2007 to August 2023 were used. Of the 11,799 patients, 8,092 with complete data were included in the final analysis. Demographic and clinical variables including age, gender, HIV status, treatment, laboratory parameters, TB infection and survival were investigated. Delayed diagnosis was defined as CD4 ≤ 350. Statistical analyzes were performed with Cox regression and survival curves (Kaplan-Meier).ResultsOut of 8092 patients, 5897 (72.8%) had delayed diagnosis. The average survival time for patients with delay was 61.55 months and without delay was 84.09 months. Delay in diagnosis increases the risk of death with HR 3.01 (95% CI: 2.67–3.40) in univariate analysis and HR 1.70 (95% CI: 1.48–1.96) in multivariate analysis. TS/TG patients had a higher risk of death than women with a HR of 1.64 (95% CI: 1.52–1.78) and patients over 45 with a HR of 2.17 (95% CI: 1.94–2.43) compared to those under 30. AIDS stage patients had a higher risk of death with HR 2.54 (95% CI: 2.34–2.75) and TB patients with HR 1.43 (95% CI: 1.31–1.56).Conclusiondelay in diagnosis, age, disease stage and the presence of TB are important factors of mortality in patients with HIV. Early diagnosis and timely management of the disease can reduce the risk of death and increase the life expectancy of patients. Programs to increase awareness and access to diagnostic and treatment services should be strengthened.
Read full abstract