Open AccessIncidence and predictors of HIV related opportunistic infections after initiation of highly active antiretroviral therapy at Ayder Referral Hospital, Mekelle, Ethiopia: A retrospective single centered cohort study
Author(s) -
Zekarias Gessesse Arefaine,
Sintayehu Abebe,
Ephrem Bekele,
Amir Adem,
Yohannes Adama,
Norbert H. Brockmeyer,
Judith Coenenberg,
Anja Potthoff,
Teferi Gebru Gebremeskel
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0229757
Subject(s) - medicine , incidence (geometry) , retrospective cohort study , tuberculosis , cohort , cohort study , pneumonia , pneumocystis pneumonia , referral , population , antiretroviral therapy , coinfection , pediatrics , immunology , viral load , human immunodeficiency virus (hiv) , pneumocystis jirovecii , pathology , environmental health , physics , family medicine , optics
Even though use of antiretroviral therapy (HAART) decreases the incidence of opportunistic infections (OIs) they are continuing to be a major cause of morbidity and mortality. Studies concerning this problem are scarce in Eastern Africa. The aim of this study was to determine the incidence and predictors of OIs after initiation of HAART in Ethiopia. Methods A health facility based single centered cohort study using structured data extraction sheet was conducted. The study population was all HIV positive ART naive adolescents and adults who started HAART between January 2009 and May 2012. Simple random sampling technique was used to select 317 patients from the record. Multivariate binary logistic regression model was used to determine factors for the occurrence of OIs after initiation of HAART. Results The incidence of OIs after HAART was 7.5 cases/100person years. Tuberculosis, oral candidiasis, pneumonia and toxoplasmosis were the leading OIs after HAART. A bed ridden functional status at initiation of HAART, presence of OIs before HAART, non-adherence and low hemoglobin level were predictors for the occurrence of OIs after HAART. Conclusion The incidence of OIs after HAART was higher than in previous studies. Patients with the identified risk factors need strict follow up to reduce the morbidity and mortality attributed to OIs. Earlier initiation of HAART before advanced immune suppression, better management of TB and extended baseline assessment could help to reduce opportunistic infections and mortality after the initiation of HAART in Ethiopian patients.