SurvivalPattern, Co-morbidity, andQuality ofLife of AdultHIV Patients onAntiretroviral Therapy inBauchi State,Nigeria
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Date
2025-12
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Lead City University, Ibadan
Abstract
Background: Antiretroviral therapy (ART) has greatly improved the survival and quality of life (QOL) for individuals living with HIV. However, challenges in the prevention of HIV-related mortality and poor retention of patients in ART treatment pose threats to effective ART interventions. The co-existence of infections and non-infectious diseases also complicate the outcomes of ART, resulting in debilitating health and poor QOL of people living with HIV (PLHIV).This study investigated the survival pattern, comorbidities, and QOL of PLHIV in Bauchi state, Nigeria. Methods: A retrospective cohort of 5,608 HIV-positive adults aged 15 years and older, from two Local Government Area (LGA) clinics between January 2020 and December 2022. A cross-sectional survey of 790 adult PLHIV, 18yrs and older, currently undergoing treatment in same facilities was also conducted between May and October 2023. Retrospective data was extracted from electronic medical record (EMR) and analyzed to assess ART outcomes including treatment interruption, lost-to-follow-up, mortality, and viral load suppression, and their incidence was determined. Kaplan-Meier survival analysis modelled probability estimates of treatment outcomes, while Cox proportional hazard was modeled to identify predictors of survival such as Body Mass Index (BMI) and viral load status. Survey dependent outcomes included symptoms, comorbidities, adherence to ART, and QOL of PLHIV measured with standardized scales. Analysis described PLHIV outcomes and their predictors. While the Structural Equation Model (SEM) was employed to test the hypothesis of the QOL scale with the domain - physical, psychological, social, environmental, spiritual, and economic - to examine how they interact and contribute to the overall quality of life. Results: Mean sample age in retrospective data was 36±8 years. Incidence of treatment interruption decreased over the three years from 33.33 to 27.23 per 100 person years (PY). Incidence of Mortality decreased from 27.78 to 0.81 per 100PY. Having viral load <1000 copies/ml exhibited significantly reduced hazards of lost-to-follow-up (HR = 0.14, 95% CI: 0.06 - 0.33, p < 0.001), and mortality (HR = 0.26, 95% CI: 0.10 - 0.64, p = 0.003) compared to those with higher viral loads. Being overweight had protective influence on mortality (HR = 0.07, 95% CI: 0.01 - 0.36, p = 0.001), while being underweight increased hazard of mortality (HR = 2.64, 95% CI: 1.07 - 6.51, p = 0.036), compared to having normal BMI. Significant burden of HIV symptoms (85%), co-infections (35%), and non-infectious comorbidity (37%) was demonstrated. Low ART adherence significantly predicted co-morbidity (OR: 3.29, 95% CI: 1.34, 8.36, p = 0.010). High ART adherence exhibited better QOL (β = -12, 95% CI: -14– -9.5, p < 0.001). SEM revealed complexities in QOL factors, indicating that the factors may not align well with the original hypothesis regarding the population. Conclusion: The findings show reductions in ART treatment interruption, lost-to-follow-up, and mortality rates, though challenges with infectious and non-infectious comorbidities, and quality of life remain. Integrated interventions should focus on improving the nutrition and health of PLHIV.
Keywords: Antiretroviral treatment outcomes, Quality of life, Comorbidities, ART adherence, PLHIV.
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Keywords
Antiretroviral treatment outcomes, Quality of life, Comorbidities, ART adherence, PLHIV.
Citation
kate Turabian