Survival time of human immunodeficiency virus (HIV) infected children under 15 years of age after initiation of antiretroviral therapy in the University of Gondar Comprehensive Specialized Hospital, Ethiopia

Abstract

Human immunodeficiency virus (HIV) has emerged as one of the leading causes of childhood mortality and morbidity in sub Saharan Africa. But, the attention given to HIV-infected children in terms of providing antiretroviral treatment (ART) had so far been ranked second. The study had the objectives of identifying predictors that had significant impacts on the survival status of HIV infected children who received antiretroviral treatment care in the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The data used in the study was based on secondary data from hospital records of HIV infected children aged below 15 years who started ART between 2008 and 2013 and who followed through April 2015 in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The Multivariable Cox Proportional model was fitted to identify factors affecting the survival of children after initiation of ART. The median survival time frame was found to be 55 months. At the end of the follow up, 46 (17.1%) children died due to the disease, the remaining 223 (82.9%) were alive and lost to followup. The multivariate analysis of the Cox Regression model showed that the age of a patients (for age < 1.5 years HR: 3.590 ; 95% CI: 1.439, 8.953; P = 0.006, baseline hemoglobin level (for hemoglobin level < 7g/dl HR: 6.286; 95% CI: 2.328, 16.973; P=0.000, WHO clinical stage (For stage III HR: 0.308 ; 95% CI: 0.150, 0.630; P = 0.001); and baseline CD4 count(HR: 0.180 ; 95% CI: 0.084, 0.388; P = 0.000) are significant factors of survival of HIV infected children during the 92 months of follow up. Therefore, special attention should be given to younger children in ART; patients with low CD4 cell count, patients with advanced WHO clinical staging (stage III and IV); and patients with low hemoglobin level to improve the survival of HIV infected children treated with ART.