Abstract:
Abstract
Antiretroviral Treatment (ART) can help people from becoming ill for many years and this has
improved the survival of HIV patients. In Ethiopia about 690,000 people and globally more than
23.3 million people have been taking ART until the end of 2018. Scaling up of ART treatment is
planned by WHO and the Ministry of Health of the Ethiopian government. Although ART
treatment has decreased HIV associated mortality and morbidity, a number of patients still die
after the start of ART. The study is designed to identify determinant factors (demographic and
health related) that affect the survival of HIV-infected patients in Debre Tabor referral hospital
with an application of parametric shared frailty models. The data were collected from the
medical chart of HIV/AIDS patients under ART follow-up from January 2015 up to December
2019. A sample of 351 patients has been taken from Debre Tabor referral hospital ART clinic
for the study. The gamma and inverse Gaussian shared frailty with exponential, Weibull,
lognormal and log-logistic baseline models was employed to analyze risk factors associated with
time to death of HIV/AIDS patients. All the fitted models were compared by using AIC and BIC.
Out of the total, about 24.8% of patients were died and 75.2% censored. The median time of
HIV/AIDS patients was 17 months. The Weibull with Gamma shared frailty model had
minimum value of AIC when compared with other models for HIV/AIDS dataset. The clustering
effect (residence) was significant for modeling the determinants of time-to-death dataset. Based
on the result of Weibull-Gamma shared frailty model, marital status, occupation, education level,
opportunistic infection disease, TB-coinfected, weight, WHO stages, CD4 cell count and age
were found to be the most significant determinants for time to death of HIV/AIDS patients.
Key words: HIV/AIDS, death, survival analysis, accelerated failure time, frailty model