Predictors of death in Malaysian HIV-infected patients on anti-retroviral therapy

Prev Med. 2013:57 Suppl:S54-6. doi: 10.1016/j.ypmed.2013.01.006. Epub 2013 Jan 22.

Abstract

Objective: To determine the predictors of death in Malaysian HIV-infected patients undergoing antiretroviral therapy (ART).

Methods: Data from 845 HIV-infected patients aged ≥ 20 years on ART in a large teaching hospital in Malaysia from 1989 to 2009 were analyzed using Kaplan-Meier and Cox regression analyses.

Results: 72.7% of the patients survived. Multivariate Cox regression showed that significant predictors of death were age ≥ 50 years (HR 1.76; 95% CI 1.18-2.64), secondary education (HR 3.57; 95% CI 1.12-11.37), tertiary education (HR 3.57; 95% CI 1.09-11.70), being unemployed (HR 1.49; 95% CI 1.07-2.09), AIDS on initial presentation (HR 5.75; 95% CI 3.29-10.07), single-drug ART (HR 1.84; 95% CI 1.27, 2.66), double-drug ART (HR 1.63; 95% CI 1.19-2.25) and inability to achieve viral load ≤ 50 copies/ml (HR 10.22; 95% CI 7.26-14.37).

Conclusion: Every effort needs to be made to ensure that all HIV patients have access to triple drug ART, to lower viral load to ≤ 50 copies/ml and to treat HIV patients before they progress to AIDS as these are significant modifiable predictors of death in Malaysian HIV patients.

Keywords: Anti-retroviral therapy; Death; HIV; Malaysian patients; Predictors; Survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Anti-HIV Agents / therapeutic use*
  • Delayed Diagnosis / mortality
  • Educational Status
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / mortality*
  • Humans
  • Kaplan-Meier Estimate
  • Malaysia / epidemiology
  • Male
  • Proportional Hazards Models
  • Survival Analysis
  • Unemployment / statistics & numerical data
  • Young Adult

Substances

  • Anti-HIV Agents