Factors Associated with Survival of HIV/HBV Co-infected Patients in Uganda

Abstract

The main objective of the study was to identify factors that affect survival of  HIV/HBV co-infected patients. The study used data from TASO Uganda. Patients  who registered with the organization between 2005 and 2010 were followed to  determine their survival. The covariates of study were age, education level, number of sex partners, Disease stage, weight, HBV related condition, being on ARV’s. To estimate the survival function for every subgroup of each variable, the product- limit method developed by Kaplan and Meier was used (Kaplan and Meier, 1958) and a log rank test to compare the survivorship functions across several groups. Lastly,a proportional hazards model was used to examine the joint effect of the covariates on the duration of survival assuming a Gompertz distribution for the time variable. The study revealed the duration of survival for HIV/HBV co-infected patients increased with increasing weight. Patients who had Hepatocellular carcinoma or Cirrhosis at diagnosis were at an increased risk of death as compared to those who had chronic active hepatitis B. Patients on ARVs had an increased death rate as compared to those who were not on ARVs, because the study showed that majority of the Patients seek for treatment when they are infected with Carcinoma, the old stage of Hepatitis B. Given the fact that ARVs have been thought to make life better for HIV/AIDS patients, there is need for further research in this area. Patients who were educated had a reduced death rate as compared to the uneducated ones. Therefore, emphasis should be on designing Information Education Communication (IEC) materials to sensitize the uneducated HIV/HBV co-infected patients on effects of non compliance and unbalanced diets.

Keywords: HIV/HBV co-infected patients, survival analysis, Kaplan and Meier  method, proportional hazards model, Uganda