Factors associated with death in human immunodeficiency virus-infected persons under antiretroviral treatment at the Walé Center in Ségou, Mali.

Abstract

Introduction: Although the role of clinical/biological factors associated with mortality has already been explored in HIV patients. However, little attention has been paid to date to the potential impact of the absence of psychosocial support on mortality in HIV-positive PLHIV. The aim of this study was to investigate not only clinico-biological factors, but also the impact of lack of psychosocial support on mortality in HIV patients. Methods and Materials: This was a cohort study. The follow-up period was 5 years (2017 to 2021). Data were collected retrospectively from the files of the 292 patients included out of a total of 320 patients. Statistical analyses were performed using R software version 4.2.2.

Results: The prevalence of death was 33% from 2017 to 2021. The crude mortality rate was 24.42 per 100 person-years. Median follow-up was 9 months with IQR: [4 ;26], sex ratio M/F was 0.9. After multivariate Cox regression analysis, the factors significantly associated with death were WHO stages 3 and 4 (HR=3, IC95%= [1.7-7.6], and (HR=14, IC95%= [6.9-32]), anemia (HR=2, IC95%= [1.1-3.8]), absence from associative activities (HR=1. 7, IC95%= [1-2.7]), not sharing serostatus with spouse (HR=2, IC95%= [1.4-3.7]), living in a rural area (HR= 2; IC95% = [2.2-3]) and men who have sex with men (HR=1.8; IC95%= [1.17-2.9]). Conclusion: The psychosocial support has a strong retention power, as it motivates HIV-positive people to accept their status, with effects on clinical and biological outcome. It is therefore useful to explore the factors that lead to early discontinuation of ARV treatment