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Predictors of Progression to Aids and Mortality Post-Hiv Infection: A Long-Term Retrospective Cohort Study Publisher Pubmed



Poorolajal J1 ; Molaeipoor L2 ; Mohraz M3 ; Mahjub H1 ; Ardekani MT4 ; Mirzapour P5 ; Golchehregan H5
Authors
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Authors Affiliations
  1. 1. Research Center for Health Sciences and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
  2. 2. Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
  3. 3. Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Science, Tehran, Iran
  4. 4. Medical Health Center, Tehran University of Medical Science, Tehran, Iran
  5. 5. Iranian Research Center for HIV/AIDS, Ministry of Health and Medical Education, Tehran, Iran

Source: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV Published:2015


Abstract

This study was conducted to better understand the prognostic factors influencing the disease progression and mortality in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in a high-middle-income country. This registry-based retrospective cohort study was conducted in Tehran from April 2004 to March 2014. We enrolled 2473 HIV-infected patients who had a medical record in Behavioral Diseases Counseling Centers. The outcomes of interest were the estimation of time: (1) from HIV diagnosis to AIDS progression and (2) from AIDS to AIDS-related death. The 1-year, 5-year, and 10-year probability of disease progression from HIV diagnosis to AIDS was 45.0%, 69.9%, and 90.4%, and that of AIDS-related death was 17.2%, 30.3%, and 39.2%, respectively. Multivariate Cox regression analysis indicated that AIDS progression was significantly associated with male sex (P = 0.022), an increase in age (P = 0.001), low educational levels (P = 0.001), and a decreased level of CD4 cell count (P = 0.001). Furthermore, the AIDS-related mortality was significantly associated with male sex (P = 0.010), tuberculosis coinfection (P = 0.001), and antiretroviral therapy (P = 0.001). The results of this study indicated that progression to AIDS and AIDS-related death is affected by several modifiable and non-modifiable predictors. We indicated that a substantial proportion of the HIV-positive people were unaware of their status and were diagnosed very late. This hidden source of HIV infection had the opportunity to transmit the infection to other people. © 2015 Taylor & Francis.