investigation of survival rate among hiv-positive individuals identified in isfahan province, 1997-2013 (iran)

Background and Objectives: AIDS is one of the most important causes of death among adults. The effect of prognostic factors on HIV-positive patients has not been properly investigated, but it can be estimated by retrospective studies. The present study was conducted with the aim of determining the survival rate among HIV-positive and AIDS patients as well as identifying important survival factors in these patients in Isfahan province.   Methods: The present study is a retrospective cohort study, in which the information of 594 HIV-positive patients of Isfahan province, were extracted from behavioral diseases counseling center and recorded in checklist. The patients' survival period for tow outcomes of the time interval between diagnosis to the progression to AIDS stage and the time interval between progression to AIDS and death, were drawn using life table and Kaplan-Meier graph. The effect of several prognostic factors on the survival time was investigated with cox proportional regression. Cox regression model was used to examine the simultaneous effect of variables on the survival time. The significance level was considered p<0.05.   Results: Out of total 594 studied patients, 504 subjects (84.8%) were male and 50.8% were in the age group of 25-34 years. The main route of transmission was intravenous drug use (70.2%). The one-year, 5-year, and 10-year survival rates after diagnosis were 97%, 75%, and 62%, respectively. The risk of death in patients with tuberculosis co-infection, was 2.1 times higher (CI, 95%: 1.35, 3.11) than patients with no history of tuberculosis. The risk of death in patients with a history of imprisonment was 12.1 times higher (CI, 95%: 1.69, 17.86).   Conclusion: based on the results of this study, the survival rate of HIV-positive patients in Isfahan province was favorable compared to other studies. Tuberculosis comorbidity as well as a history of imprisonment are also among the most important prognostic factors for survival time in the patients. Therefore, it is necessary that imprisoned patients have appropriate and favorable access to care and treatment services.