MORTALITY OF HIV/AIDS-INFECTED PEOPLE WITH ANTIRETROVIRAL THERAPY: A GENDER ANALYSIS

Putu Dian Prima Kusuma Dewi, Putu Sukma Megaputri, Lina Anggaraeni Dwijayanti, Dewa Ayu Putu Indra Pranita, Made Juniari Dewi

Abstract


Background: Mortality in people living with HIV/AIDS is one of measures to the success of its treatment. Study related to their deaths seen from gender is still very limited.

Objective: The aim of this study was to determine the incidence rate of mortality between men and women living with HIV/AIDS and receiving antiretroviral therapy.

Methods: This was a retrospective study using secondary data of HIV/AIDS-infected patients in Buleleng District Hospital in the period of 2006-2015. This research used Survival analysis, Kaplan-meier, incident rate comparison and logistic regression with STATA SE 12.

Results: A total of 1204 HIV/AIDS-infected patients data was included. The incidence of total mortality rates was 27.7 per 1000 person-years. Based on gender, the mortality in men (35 per 1000 person-years) was higher than women (14 per 1000 person-years) with the incidence rate ratio (IRR) of 2.39 (p 0.01).  Fifty percent of cases of mortality occured at 0.15 years of observation. The median time of mortality in men was 0.14 years (1.7 months) and in women was 0.15 years (1.8 months). The poor clinical condition was seen from a body weight <50 kg, which increased the risk of death with aOR 3.85 (p 0.01 CI 2.40-6.16). Nevirapine increased the risk of mortality (aOR 2.18; p 0.01; CI 1.18-4.03). and CD4 cell counts of ≤ 200 cells / mm3 reduced the risk of death by 69% (AOR 0.31; p 0.01; CI 0.18-0.53).

Conclusion: The incidence of mortality in men was greater than it in women, which is caused by poor clinical conditions. It is better to evaluate the success of antiretroviral therapy by considering the needs of patients according to their gender. Further research is needed in regard to adherence of treatment and loss to follow-up events.


Keywords


HIV/AIDS; gender; mortality; antiretroviral therapy

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References


Applebaum, A. J., Richardson, M. A., Brady, S. M., Brief, D. J., & Keane, T. M. (2009). Gender and other psychosocial factors as predictors of adherence to highly active antiretroviral therapy (HAART) in adults with comorbid HIV/AIDS, psychiatric and substance-related disorder. AIDS and Behavior, 13(1), 60-65. doi:10.1007/s10461-008-9441-x

ASEAN Nations. (2011). ASEAN Declaration of Commitment: Getting To Zero New HIV Infection, Zero Discrimination, Zero AIDS-Related Deaths. Retrieved from Association of Southeast Asian Nations: https://www.asean.org/uploads/2012/05/ASEAN_Declaration_of_Commitment.pdf

Brinkhof, M. W., Pujades-Rodriguez, M., & Egger, M. (2009). Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis. PLoS ONE, 4(6), e5790.

Brinkhof, M. W., Spycher, B. D., Yiannoutsos, C., Weigel, R., Wood, R., Messou, E., . . . AIDS, I. e. D. t. E. (2010). Adjusting mortality for loss to follow-up: analysis of five ART programmes in sub-Saharan Africa. PLoS ONE, 5(11), e14149.

Clouse, K., Pettifor, A., Maskew, M., Bassett, J., Van Rie, A., Gay, C., . . . Sanne, I. (2013). Initiating ART when presenting with higher CD4 counts results in reduced loss to follow-up in a resource-limited setting. AIDS (London, England), 27(4), 645.

Dalal, R. P., MacPhail, C., Mqhayi, M., Wing, J., Feldman, C., Chersich, M. F., & Venter, W. D. (2008). Characteristics and outcomes of adult patients lost to follow-up at an antiretroviral treatment clinic in Johannesburg, South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes, 47(1), 101-107.

Ford, N., Calmy, A., Andrieux-Meyer, I., Hargreaves, S., Mills, E. J., & Shubber, Z. (2013). Adverse events associated with nevirapine use in pregnancy: a systematic review and meta-analysis. AIDS, 27(7), 1135-1143.

Gabillard, D., Lewden, C., Ndoye, I., Moh, R., Segeral, O., Tonwe-Gold, B., . . . Eholié, S. (2013). Mortality, AIDS-morbidity and loss to follow-up by current CD4 cell count among HIV-1 infected adults receiving antiretroviral therapy in Africa and Asia: data from the ANRS 12222 collaboration. Journal of acquired immune deficiency syndromes (1999), 62(5), 555.

Hawkins, C., Chalamilla, G., Okuma, J., Spiegelman, D., Hertzmark, E., Aris, E., . . . Fawzi, W. (2011). Sex differences in antiretroviral treatment outcomes among HIV-infected adults in an urban Tanzanian setting. AIDS, 25(9), 1189-1197.

Kusuma Dewi, P. D. P., & Widiarta, G. B. (2018). Predictors of Mortality among Patients Lost to Follow up Antiretroviral Therapy. 2018, 13(1), 8. doi:10.20473/jn.v13i1.6568

Lamb, M. R., El-Sadr, W. M., Geng, E., & Nash, D. (2012). Association of adherence support and outreach services with total attrition, loss to follow-up, and death among ART patients in sub-Saharan Africa. PLoS ONE, 7(6), e38443.

Mitra, A., & Sarkar, D. (2011). Gender inequality and the spread of HIV-AIDS in India. International Journal of Social Economics, 38(6), 557-572.

MOH. (2010). Indonesia’s national aids strategy and action plan 2010-2014 Retrieved from Ministry of Health of the Republic of Indonesia: http://www.aidsdatahub.org/sites/default/files/documents/Indonesia_NSP_2010-14.pdf

MOH. (2011a). Instructions for Filling in the Format of Patient HIV / AIDS Recording and Reporting. Jakarta: Ministry of Health of the Republic of Indonesia.

MOH. (2011b). National Guidelines for Clinical Management of HIV Infection and Antiretroviral Therapy in Adults. Jakarta: Ministry of Health of the Republic of Indonesia.

Mugisha, V., Teasdale, C. A., Wang, C., Lahuerta, M., Nuwagaba-Biribonwoha, H., Tayebwa, E., . . . Twyman, P. (2014). Determinants of mortality and loss to follow-up among adults enrolled in HIV care services in Rwanda. PLoS ONE, 9(1), e85774.

Taylor-Smith, K., Tweya, H., Harries, A., Schoutene, E., & Jahn, A. (2010). Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi. Malawi Medical Journal, 22(2).

Weigel, R., Estill, J., Egger, M., Harries, A., Makombe, S., Tweya, H., . . . Keiser, O. (2012). Mortality and loss to follow-up in the first year of ART: Malawi national ART programme. AIDS (London, England), 26(3).

WHO. (2013). Global update on HIV treatment 2013: results, impact and opportunities. Geneva: World Health Organization.

Wilkinson, L. S., Skordis‐Worrall, J., Ajose, O., & Ford, N. (2015). Self‐transfer and mortality amongst adults lost to follow‐up in ART programmes in low‐and middle‐income countries: systematic review and meta‐analysis. Tropical Medicine and International Health, 20(3), 365-379.

Wubshet, M., Berhane, Y., Worku, A., & Kebede, Y. (2013). Death and seeking alternative therapy largely accounted for lost to follow-up of patients on ART in northwest Ethiopia: a community tracking survey. PLoS ONE, 8(3), e59197.


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