Research Article Determinants of Mortality among Adult HIV-Infected Patients on Antiretroviral Therapy in a Rural Hospital in Southeastern Nigeria: A 5-Year Cohort Study Kelechi N. Eguzo, 1,2 Adegboyega K. Lawal, 1 Cynthia E. Eseigbe, 3 and Chisara C. Umezurike 2 1 School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5 2 Department of Obstetrics and Gynecology, Nigerian Christian Hospital, Aba, Abia State 450001, Nigeria 3 Department of Laboratory Services, Nigerian Christian Hospital, Aba, Abia State 450001, Nigeria Correspondence should be addressed to Kelechi N. Eguzo; keguzo@gmail.com Received 14 February 2014; Revised 10 July 2014; Accepted 10 July 2014; Published 6 August 2014 Academic Editor: P. K. Nicholas Copyright © 2014 Kelechi N. Eguzo et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Study examined the determinants of mortality among adult HIV patients in a rural, tertiary hospital in southeastern Nigeria, comparing mortality among various ART regimens. Methods. Retrospective cohort study of 1069 patients on ART between August 2008 and October 2013. Baseline CD4 counts, age, gender, and ART regimen were considered in this study. Kaplan-Meier method was used to estimate survival and Cox proportional hazards models to identify multivariate predictors of mortality. Median follow-up period was 24 months (IQR 6–45). Results. 78 (7.3%) patients died with 15.6% lost to followup. Signifcant independent predictors of mortality include age (>45), sex (male > female), baseline CD4 stage (<200), and ART combination. Adjusted mortality hazard was 3 times higher among patients with CD4 count <200 cells/L than those with counts >500 (95% CI 1.69–13.59). Patients on Truvada-based frst-line regimens were 88% more likely to die than those on Combivir-based frst line (95% CI 1.05–3.36), especially those with CD4 count <200 cells/L. Conclusion. Study showed lower mortality than most studies in Nigeria and Africa, with mortality higher among males and patients with CD4 count <200. Further studies are recommended to further compare treatment outcomes between Combivir- and Truvada-based regimens in resource-limited settings using clinical indicators. 1. Introduction In 2008, it was estimated that 33.4 million people were living with HIV/AIDS worldwide, with about 70% of those in sub-Saharan Africa [1]. Poor access to treatment services, poverty, and ignorance have contributed to the high mortality associated with this disease in the region [2]. Following the discovery of the disease in Nigeria in 1986, there has been signifcant development in eforts to combat HIV/AIDS, including scaling up of antiretroviral treatment (ARTs). Tis increased the number of people accessing ARTs from 10,000 (2002) to 300,000 (2010) [3]. Nigerian Christian Hospital is one such treatment facility that was activated in August 2008 in southeastern Nigeria. However, few studies have been conducted to investigate the determinants of mortality for people using ART services in southeastern Nigeria. Onoka et al. studied HIV programs in this region and reported loss-to-follow-up (LTFU) rate between 11 and 32.8% [4]. Tey also showed that mortality among patients in the programs reviewed ranged from 34.2% to 56.7%. Males and patients CD4 cell count ≤200 had higher rates of LTFU; this study did not explore the pattern of mortality based on drug treatment. Ogoina et al. studied the pattern of morbidity and mortality among hospitalized patients on ARTs [5]. Tis study estimated a mortality rate of 31.9%, mostly due to disseminated tuberculosis and sepsis. Death was higher among males and people with lower CD4- cell count. Tere was no statistical diference in mortality based on participation in ART program. Some researchers (Bedavid et al. and Valen et al.) have also suggested that Truvada-based 1st line regimen had better survival profle than Combivir-based 1st line drugs [6, 7]. But, there is Hindawi Publishing Corporation AIDS Research and Treatment Volume 2014, Article ID 867827, 6 pages http://dx.doi.org/10.1155/2014/867827