Ethiop. j. public health nutr. Volume 3 Issue 1 ISSN 2709-1341 1 https://ejphn.ephi.gov.et/ Predictors of survival in HIV-infected patients under antiretroviral treatment in selected hospitals of Ethiopia Theodros Getachew * , Girum Taye, Atkure Defar, Tefera Taddele, Habtamu Teklie and Abebe Bekele Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, P.O.Box 1242 Addis Ababa, Ethiopia *Corresponding author: tedi.getachew@yahoo.com, Tel +251 911 658 095 Abstract Introduction: In spite of the availability of large number of researches that address issues about HIV/AIDS in Ethiopia, evidence on survival and mortality indicators are insignificant. Objective: To assess survival and indicators for mortality of HIV-positive patients receiving ART in Ethiopia. Method: A retrospective facility-based register review was done in 31 purposively selected hospitals across the country. A 15 years data from medical records were included in the analysis. Cox proportional hazards regression was done to identify factors independently associated with survival. Relative risks (hazard ratio) with 95% CI and two- sided test of significance was used to measure the association between dependent and independent variables. Result: From the total 83,876 (56.12%) patient records reviewed, 65,333 (43.71%) were females and the rest were males. Among the total patient records, 10.91% were record of dead people, 47.1% were alive, 22.84% were transferred out, and 13.3% were lost to follow up. About three fourth of patients (77.6 %) were actively working, while 11.65% and 6.71% were ambulatory and bed ridden patients respectively. Death rate among patients on ART was 11.1 per 1,000 Person-year while it is 12.2 per 1,000 Person-year among patients on Pre ART. According to the Kaplan Meier Life Table, the survival probability of patients on ART in the first four years was greater than 95%, and gradually decreased to 78% survival by the end of the 15 years follow-up. Cox proportional hazard model shows that Region, sex, CD4 cell count at ART initiation, functional status, CD4 count at outcome, weight, and age were independent factors associated with death. Conclusion: The overall survival rate in this study was high. Low rate of survival was predicted by sex, region, CD4 count at ART initiation, functional status, and CD4 count at outcome, weight, and age. Key words: Peredictors of survival, HIV infected, antiretroviral Introduction HIV/AIDS is a worldwide pandemic (Cohen 2008). All inclusive, roughly 36.7 million individuals were living with HIV/AIDS in 2016 (UNAIDS 2016). There were around 1 million deaths from AIDS in 2016, down from 1.9 million in 2005 (UNAIDS 2016). The 2015 Global Burden of Disease Study published in Lancet, reported that worldwide the number of new HIV infections topped in 1997 at 3.3 million. Worldwide the number of new infection fell from 3.3 in 1997 to 2.6 million in 2005, then remained stable from 2005 to 2015 (Wang 2015). Sub-Saharan Africa is the region hardest hit by the pandemic. According to UNAIDS 2011 report, an estimated 68% (22.9 million) of all HIV cases and 66% of all deaths (1.2 million) happened in this region. This implies around 5% of the grown-up population are infected. East and Southern Africa is home to 6.2% of the total population but home for 19.4 million individuals living with HIV i.e. more than half of the aggregated number of individuals living with HIV on the planet. In 2016, there were 790,000 new HIV infections, 43% of the worldwide aggregate (Avert 2018). The new HIV infection in sub-Saharan African nations has demonstrated a decrease trend by over 33% from an estimated 2.2 million in 2005 to 1.5 million in 2013 and yet it is still high. The scale up of Antiretroviral therapy/treatment (ART) has brought significant decreases in the HIV incidence. HIV exposed people living in areas with ART coverage of 30 to 40% were 38% less likely to acquire new HIV infection than those living in areas where ART coverage was less than 10% (Ayesha 2016). ART is used to combat HIV infection by controlling viral replication. ART programs have been scaled-up drastically in East and Southern Africa over the past decades. With expanded access to ART, the number of AIDS related deaths have consistently declined globally and in sub- Saharan Africa there was a 39% decrease between 2005 and 2013 (UNAIDS 2014). In East and Southern Africa, about 11.7 million individuals were on ART in 2016, which means 79% of the individuals living with HIV. Around the same time, pediatric treatment coverage expanded to 51% from 19% in 2010 (Avert 2018).