Mortality of HIV-Infected Patients on Antiretroviral Therapy in a Large Public Cohort in West Africa, Burkina Faso: Frequency and Associated Factors

Armel Poda, Arsène Hema, Jacques Zoungrana, Nongodo Firmin Kaboré, Bebar Euloges Kamboulé, Ibrahim Soré, Guillaume Bado, Abdoul-Salam Ouédraogo, Nicolas Meda, Adrien Bruno Sawadogo

Day Care Hospital for HIV-Patients of Bobo Dioulasso, Department of Infectious Diseases, Souro Sanou Teaching Hospital, Bobo Dioulasso, Burkina Faso.
Day Care Hospital for HIV-Patients of Bobo Dioulasso, Department of Infectious Diseases, Souro Sanou Teaching Hospital, Bobo Dioulasso, Burkina Faso；Department of Virology and Bacteriology, Souro Sanou Teaching Hospital, Bobo Dioulasso, Burkina Faso.
School of Medicine, University of Bobo Dioulasso, Bobo Dioulasso, Burkina Faso；Day Care Hospital for HIV-Patients of Bobo Dioulasso, Department of Infectious Diseases, Souro Sanou Teaching Hospital, Bobo Dioulasso, Burkina Faso.
School of Medicine, University of Bobo Dioulasso, Bobo Dioulasso, Burkina Faso；Department of Virology and Bacteriology, Souro Sanou Teaching Hospital, Bobo Dioulasso, Burkina Faso.
School of Medicine, University of Ouagadougou, Ouagadougou, Burkina Faso；Muraz Center, Bobo Dioulasso, Burkina Faso.

DOI: 10.4236/aid.2013.34043                

Abstract

Background: In sub Saharan Africa, small size surveys have demonstrated early high mortality among infected patients on antiretroviral therapies (ART). Few studies have been conducted in large cohorts of HIV-patients in public health care system in West Africa. Objectives: Our study aims to determine mortality rate and its predictors in a cohort of patients on ART in a public daycare hospital in Burkina Faso. Methods: We have carried out a retrospective cohort study. All HIV-infected patients on ART between January 1st 2008 and December 31st 2011 were included in the study. Survival probability was estimated by the Kaplan-Meier method. Cox regression analysis was used to identify associated factors to mortality. Results: A total of 2243 HIV-infected patients were included in the study. During the follow-up, 218 patients representing 9.7% were lost. About 104 patients representing 4.6% were transferred and 1691 representing 75.4% were still in the therapeutic cohort. There were 230 death cases for a total of 4282 persons-years, (5.4 deaths for 100 persons-years; 95% CI: 4.8 -6.3). The survival probabilities after 6 months, 1 year and 2 years were 92.6%, 91% and 88.9% respectively. For the multivariate analysis, the following factors were independently associated to death: male gender, BMI < 18.5 kg/m², WHO stage 3 and 4, HIV-2, T-CD4 lymphocytes < 200/μl, haemoglobin rate < 8 g/dl and creatinine clearance < 60 ml/m². Conclusions: Our study provides for the first time mortality rates and its predictors among HIV-patients on antiretroviral treatment in a large cohort in public health sector in Burkina Faso. It highlights the importance of early HIV screening to limit ART initiation at advanced HIV infection stages.

Keywords

Antiretroviral Therapy; Burkina Faso; HIV; Mortality; West Africa

Conflicts of Interest

The authors declare no conflicts of interest.

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