Original research article Survival rate of AIDS disease and mortality in HIV-infected patients in Hamadan, Iran: a registry-based retrospective cohort study (1997–2011) Mohammad Mirzaei 1 , Jalal Poorolajal 2 , Salman Khazaei 3 and Mohammad Saatchi 3 Summary There remains a need to better understand the prognostic factors affecting the long-term survival in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), particularly in developing countries. We extracted data from 585 patients’ medical records available at the triangular clinics for behavioural diseases. The outcomes of interest were the survival rates of progression to AIDS and death in HIV-positive subjects. The effect of several prognostic factors on survival time was investigated. One-year, five-year and 10-year survival rates from time of HIV diagnosis to AIDS were 89%, 69% and 30%, respectively. One-year and five-year survival rates from AIDS to death were 76% and 46%, respectively. One-year, five-year and 10-year survival rate from HIV diagnosis to death were 87%, 67% and 40%, respectively. Hazard ratio of progression to AIDS in HIV-positive subjects who were co- infected with tuberculosis was 4.50 (p < 0.001). Hazard ratio of death from AIDS-related causes was 4.77 in patients who did not receive highly active antiretroviral therapy compared to those who did (p < 0.001). Co-infection with tubercu- losis was one of the most important prognostic factors of progression to AIDS and antiretroviral treatment was found to be an effective measure in suppressing HIV viral replication and improving the survival of patients living with HIV. Keywords HIV, AIDS, mortality, tuberculosis, antiretroviral therapy, survival rate, cohort studies, Iran Date received: 6 December 2012; accepted: 24 March 2013 Introduction The human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) epidemic are now considered the world’s most serious public health threat. 1 There is no cure for AIDS at this time. However, HIV-related mortality has decreased since the inception of combination antiretroviral therapy (ART). 2 Several treatments are available that can delay the progression of disease for many years and improve the quality of life of HIV/AIDS patients. With the advent of antiretroviral medications, HIV- positive patients can now stay healthy, live longer and have hope after their diagnosis. 3 ART has increased the life expectancy of patients who are infected with HIV and has reduced the incidence of illnesses associated with the AIDS. 4 It is estimated that ART has prevented 1 Department of Health Services, Hamadan University of Medical Sciences, Hamadan, Iran 2 Research Center for Health Sciences, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 3 Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Corresponding author: Jalal Poorolajal, Research Center for Health Sciences, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Shahid Fahmideh Ave., Hamadan 6517838695, Iran. Email: poorolajal@umsha.ac.ir; poorolajal@yahoo.com International Journal of STD & AIDS 24(11) 859–866 ! The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0956462413486457 std.sagepub.com