Predictors of death in Malaysian HIV-infected patients on anti-retroviral therapy.
OBJECTIVE
To determine the predictors of death in Malaysian HIV-infected patients undergoing antiretroviral therapy (ART).


METHODS
Data from 845 HIV-infected patients aged ≥ 20 years on ART in a large teaching hospital in Malaysia from 1989 to 2009 were analyzed using Kaplan-Meier and Cox regression analyses.


RESULTS
72.7% of the patients survived. Multivariate Cox regression showed that significant predictors of death were age ≥ 50 years (HR 1.76; 95% CI 1.18-2.64), secondary education (HR 3.57; 95% CI 1.12-11.37), tertiary education (HR 3.57; 95% CI 1.09-11.70), being unemployed (HR 1.49; 95% CI 1.07-2.09), AIDS on initial presentation (HR 5.75; 95% CI 3.29-10.07), single-drug ART (HR 1.84; 95% CI 1.27, 2.66), double-drug ART (HR 1.63; 95% CI 1.19-2.25) and inability to achieve viral load ≤ 50 copies/ml (HR 10.22; 95% CI 7.26-14.37).


CONCLUSIONS
Every effort needs to be made to ensure that all HIV patients have access to triple drug ART, to lower viral load to ≤ 50 copies/ml and to treat HIV patients before they progress to AIDS as these are significant modifiable predictors of death in Malaysian HIV patients.
Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Rahayu
R
Lubis
Awang
A
Bulgiba
Adeeba
A
Kamarulzaman
Noran N
NN
Hairi
Maznah
M
Dahlui
Devi
D
Peramalah
D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D057210:Delayed Diagnosis / Q000401:mortality; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult
D019380:Anti-HIV Agents
Anti-retroviral therapy; Death; HIV; Malaysian patients; Predictors; Survival