ArticleBMC infectious diseases2025
Factors associated with mortality among people with advanced HIV disease in rural uganda: a retrospective study.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Factors influencing the survival of patients with advanced HIV disease in Guinea from 2015 to 2024.BMC public health · 2026Article
- Survival and risk factors of mortality among patients with TB/HIV coinfection in Kigali City, Rwanda: a retrospective cohort study (2019-2024).BMC infectious diseases · 2026Article
- Epidemiology of human papillomavirus among women living with HIV in rural Uganda: a retrospective cohort study.BMC infectious diseases · 2026Article
- Effect of facility- versus community-based HIV testing services on the diagnosis of advanced HIV disease in Uganda: a quasi-experimental study.BMC infectious diseases · 2025Article
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18 authors.
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Abstract
backgroundDespite global efforts to improve HIV care, late diagnosis and delayed antiretroviral therapy (ART) initiation continue to pose mortality risks among people living with HIV (PLHIV) with advanced HIV disease (AHD). This study investigated factors associated with mortality among PLHIV with AHD in rural North-Central Uganda from January 2018 to December 2021.
methodsWe retrospectively reviewed electronic medical records from 18 health facilities, collecting data on demographics and clinical characteristics, including baseline CD4 count, ART regimen, BMI, TB status, TPT use, WHO clinical stage, and viral load. AHD was defined as a baseline CD4 < 200 cells/mm³. Cox proportional hazards modeling identified mortality-associated factors, reported as adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs), using a 5% significance level.
resultsWe analyzed 1161 PLHIV with AHD, contributing 1565.6 person-years. There were 84 deaths (7.2%), yielding a mortality rate of 5.4 per 100 person-years (95% CI: 4.33-6.64). Mortality was significantly associated with age ≥ 50 years (aHR 4.16 [1.77-9.77]), no viral load test (aHR 16.23 [7.44-35.39]), viral load non-suppression (aHR 9.05 [3.37-24.29]), CD4 ≤ 50 (aHR 1.91 [1.08-3.39]), no TB prophylaxis (aHR 3.51 [1.83-6.74]), and WHO stage 3 or 4 (aHR 1.91 [1.12-3.27]).
conclusionDespite advances in HIV programs, the mortality rate among patients with AHD highlights ongoing challenges. Early identification of AHD patients, regular viral load testing, optimizing ART and ensuring adherence, along with promoting tuberculosis preventive therapy, could help reduce mortality, improve patient outcomes, and achieve HIV epidemic control by 2030.
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