Determinants of survival in HIV patients receiving antiretroviral therapy in Goma, Democratic Republic of Congo

Background. - The study aimed to identify factors associated with the survival of patients receiving antiretroviral therapy. Methods. - A historic cohort of HIV patients from two major hospitals in Goma (Democratic Republic of Congo) was followed from 2004 to 2012. The Kaplan-Meier method was used to describe the probability of survival as a function of time since inclusion into the cohort. The log-rank test was used to compare survival curves based on determinants. The Cox regression model identified the determinants of survival since treatment induction. Results. - The median follow-up time was 3.56 years (IQR = 2.22-5.39). The mortality rate was 40 deaths per 1000 person-years. Male gender (RR: 2.56; 95% CI 1.66-4.83), advanced clinical stage (RR: 2.12; 95% CI 1.15-3.90), low CD4 count (CD4 < 50) (RR: 2.05; 95% CI : 1.22-3.45), anemia (RR: 3.95; 95% CI 2.60-6.01), chemoprophylaxis with cotrimoxazole (RR: 4.29, 95% CI 2.69-6.86) and period of treatment initiation (2010-2011) (RR: 3.34; 95% CI 1.24-8.98) were statistically associated with short survival. Conclusion. - Initiation of treatment at an early stage of the disease with use of less toxic molecules and an increased surveillance especially of male patients are recommended to reduce mortality. (C) 2014 Elsevier Masson SAS. All rights reserved.