Predictors of death in Malaysian HIV-infected patients on anti-retroviral therapy.

Prev Med. 2013 Jan 22. pii: S0091-7435(13)00019-4. doi: 10.1016/j.ypmed.2013.01.006. [Epub ahead of print]


Lubis R, Bulgiba A, Kamarulzaman A, Hairi NN, Dahlui M, Peramalah D.


Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.


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

METHODS: Data from 845 HIV-infected patients aged ≥20years 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 ≥50years (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 ≤50copies/ml (HR 10.22; 95% CI 7.26-14.37).

CONCLUSION: Every effort needs to be made to ensure that all HIV patients have access to triple drug ART, to lower viral load to ≤50copies/ml and to treat HIV patients before they progress to AIDS as these are significant modifiable predictors of death in Malaysian HIV patients. Copyright 2013 Elsevier Inc. All rights reserved.


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