Hindawi Publishing Corporation ISRN AIDS Volume 2013, Article ID 491601, 7 pages http://dx.doi.org/10.1155/2013/491601 Clinical Study Determinants of Mortality among HIV Positives after Initiating Antiretroviral Therapy in Western Ethiopia: A Hospital-Based Retrospective Cohort Study Mitiku Teshome Hambisa, 1 Ahmed Ali, 2 and Yadeta Dessie 1 1 Department of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia 2 Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, P.O. Box 25819/1000, Addis Ababa, Ethiopia Correspondence should be addressed to Mitiku Teshome Hambisa; mitikkuuf@gmail.com Received 16 December 2012; Accepted 16 January 2013 Academic Editors: V. C. Bond and V. Venketaraman Copyright © 2013 Mitiku Teshome Hambisa 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. Studies revealed that there are various determinants of mortality among HIV positives afer ART initiation. Tese determinants are so variable with context and dynamic across time with the advancement of cares and treatments. In this study we tried to identify determinants of mortality among HIV positives afer initiating ART. A retrospective cohort study was conducted among 416 ART attendees enrolled between July 2005 to January 2012 in Nekemte Referral Hospital, Western Ethiopia. Actuarial table was used to estimate survival of patients afer ART initiation and log rank test was used to compare the survival curves. Cox proportional- hazard regression was applied to determine the independent determinants of time to death. Te estimated mortality was 4%, 5%, 6%, 7%, and 7% at 6, 12, 24, 36 and 48 months respectively with mortality incidence density of 1.89 deaths per 100 person years (95% CI 1.74, 3.62). Forty years and above AHR = 3.055 (95% CI 1.292, 7.223), low baseline hemoglobin level (AHR = 0.523 (95% CI .335, 0.816)), and poor ART adherence (AHR 27.848 (95% CI 8.928, 86.8)) were found to be an independent determinants of mortality. Tese determinants of mortality have to be taken into account to enhance better clinical outcomes of ART attendees. 1. Introduction HIV/AIDS remains one of the leading causes of death glob- ally. It is projected to continue as a signifcant cause of pre- mature mortality [1]. According to the joint 2011 HIV/AIDS report of WHO, UNAIDS, and UNICEF, an estimated 34 million people were living with HIV/AIDS globally with 2.7 million new HIV infections in 2010. Of these, 68% were residing in sub-Saharan Africa [2]. Ethiopia is one of the seriously afected countries in sub-Saharan Africa with a large number of people (approximately 800,000) that are living with HIV/AIDS and 44,751 AIDS-related deaths. An esti- mated number of 249,174 adults (86% of eligible) are on ART treatment [3–5]. Te average life expectancy at birth is low, 51 years for males and 53 years for females. It is expected to further decline if the present HIV infection rates continue [3]. Diferent studies from diferent countries reported that WHO clinical staging, viral load, age, gender, CD4 cell count, total lymphocyte count (TLC), body mass index (BMI), ART adherence, and baseline hemoglobin level were determinants of mortality [6–10]. Even though studies had identifed these determinants of mortality, they are so variable with context and dynamic across time with advancement of care and treatments as many years are being spent on highly active antiretroviral therapy (HAART) [11]. Tus, it is needed to generate locally consumable data to provide evidence for organizations working on HIV/AIDS and ART at national, regional, and district levels on factors determining the mor- tality of HIV positives attending ART. Terefore, the objective of this study was to identify independent determinants of mortality in PLWHA afer initiation of ART and to estimate the time of death of PLWHA who are on ART. Important baseline variables like BMI, CD4 count, and TLC were included in this study to address the limitations of the previous cohort studies done in Ethiopia.