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Investegation of Factors Associated With Tcd4 + Lymphocyte Count Change and Survival of Hiv+ Patients Using Joint Model With Longitudinal and Survival Measurements Publisher



Darab SM1 ; Almasi A2 ; Shahsavari S3 ; Shakiba E4 ; Madreseh E5
Authors
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Authors Affiliations
  1. 1. Department of Biostatistics School of Public Health, Student’s Research Committee, Kermanshah University of Medical Science, Kermanshah, Iran
  2. 2. Department of Biostatistics School of Health, Cardiovascular Research Center Research Institute for Health, Kermanshah University of Medical Science, Kermanshah, Iran
  3. 3. Department of Health Information Technology, Faculty of Para Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  4. 4. Department of Biochemistry School of Medicine, Social Development and Health Promotion Research Center Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  5. 5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Scientific Journal of Kurdistan University of Medical Sciences Published:2021


Abstract

Background and Aim: Human immunodeficiency virus (HIV) is now a major global health problem. The aim of this study was to determine factors affecting the change in TCD4+ lymphocyte count and survival of HIV patients simultaneously in Kermanshah Province, using a joint model for longitudinal and survival time measurements. Materials and Methods: In this retrospective cohort study we extracted data of 614 HIV+ patients receiving antiretroviral therapy from the Registry of Behavioral Disease Counseling Center of Kermanshah Province from 2001 to 2018. Data included variables of  longitudinal TCD4+ and survival of patients (time interval from HIV diagnosis to death) as response. Then, using a joint model, the relationship between TCD4+ and the survival of patients was determined. Data analysis was performed using R (3.4.3) software package JM. P< 0.05 was considered significant. Results: In the joint model, sex, age at the time of diagnosis, marital status, history of addiction, education level, time, and presence of tuberculosis had a significant relationship with TCD4+ lymphocyte count (p<0.05). Tuberculosis (HR=2.624) was an effective risk factor for death of HIV patients (p<0.001). There was a significant relationship between the two responses (p<0.001) so that 1-unit decrease in the number of TCD4+ lymphocytes led to a 36.5% increase in the risk of death over time. Conclusion: Since HIV+ patients are exposed to the risk of development of tuberculosis, a decrease in the number of TCD4 + lymphocytes may be a good prognostic indicator for death in HIV patients. © 2018 the Author (s).
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