Table 3.
Predictors of the unfavourable outcome for patients with advanced HIV disease (Treat‐All and SOC combined) initiated on first‐line ART (n = 1080)
| Univariate analysis | Multivariate analysisa | |
|---|---|---|
| HR (95% CI) | aHR (95% CI) | |
| Health zone | ||
| SOC | 1 | 1 |
| Treat‐All | 1.15 (0.93 to 1.43) | 1.13 (0.88 to 1.44) |
| Implementation periodb | ||
| Period‐1 | 1 | 1 |
| Period‐2 | 0.87 (0.68 to 1.10) | 0.83 (0.64 to 1.07) |
| Facility | ||
| PHC | 1 | 1 |
| SHCc | 0.88 (0.71 to 1.10) | 0.84 (0.65 to 1.07) |
| Time since HIV diagnosisd | ||
| ≥90 days | 1 | 1 |
| 1 to 89 days | 0.80 (0.63 to 1.04) | 0.86 (0.62 to 1.18) |
| Same day | 0.94 (0.67 to 1.33) | 0.65 (0.42 to 1.00) |
| Time since HIV care enrolmente | ||
| ≥90 days | 1 | 1 |
| 1 to 89 days | 0.73 (0.50 to 1.07) | 0.84 (0.53 to 1.36) |
| Same day | 1.00 (0.67 to 1.48) | 1.21 (0.75 to 1.96) |
| Sex | ||
| Men | 1 | 1 |
| Women | 1.29 (1.04 to 1.60) | 1.17 (0.91 to 1.51) |
| Pregnancy | ||
| No | 1 | 1 |
| Yes | 1.07 (0.76 to 1.51) | 1.03 (0.69 to 1.53) |
| Age at HIV care enrolment, years | ||
| 16 to 24 | 1.46 (1.08 to 1.99) | 1.22 (0.87 to 1.72) |
| 25 to 49 | 1 | 1 |
| ≥50 | 0.91 (0.64 to 1.31) | 1.08 (0.74 to 1.59) |
| Marital status | ||
| Married | 1 | 1 |
| Not married | 1.76 (1.40 to 2.21) | 1.53 (1.19 to 1.97) |
| Education | ||
| None | 1 | 1 |
| Primary | 1.11 (0.71 to 1.73) | 1.08 (0.68 to 1.71) |
| Secondary | 0.99 (0.65 to 1.51) | 0.97 (0.62 to 1.51) |
| Tertiary | 1.16 (0.46 to 2.91) | 1.10 (0.41 to 2.91) |
| CD4 count, cells/mm3 | ||
| 0 to 100 | 1.39 (0.85 to 2.26) | 1.59 (0.94 to 2.68) |
| 101 to 200 | 1.05 (0.64 to 1.72) | 1.35 (0.78 to 2.33) |
| 201 to 350 | 1 | 1 |
| ≥351 | 0.98 (0.50 to 1.93) | 1.05 (0.52 to 2.12) |
| WHO clinical stage | ||
| I | 1 | 1 |
| II | 1.10 (0.82 to 1.48) | 1.03 (0.75 to 1.41) |
| III/IV | 1.20 (0.94 to 1.51) | 1.22 (0.91 to 1.66) |
| Tuberculosis | ||
| No | 1 | 1 |
| Yes | 0.94 (0.71 to 1.26) | 0.76 (0.56 to 1.04) |
| BMI, kg/m2 | ||
| <18.5 | 1.87 (1.42 to 2.47) | 1.89 (1.40 to 2.54) |
| 18.5 to 24.9 | 1 | 1 |
| ≥25 | 0.87 (0.67 to 1.14) | 0.94 (0.70 to 1.26) |
| Haemoglobin, g/dL | ||
| ≤9 | 1.63 (1.28 to 2.08) | 1.43 (1.09 to 1.87) |
| ≥10 | 1 | 1 |
| ALT, U/L | ||
| ≤42 | 1 | 1 |
| ≥43 | 1.24 (1.01 to 1.54) | 1.03 (0.80 to 1.33) |
| Creatinine, µmol/L | ||
| ≤120 | 1 | 1 |
| ≥121 | 1.67 (1.33 to 2.09) | 1.77 (1.35 to 2.32) |
| NRTI | ||
| TDF | 1 | 1 |
| AZT | 1.29 (0.78 to 2.12) | 1.03 (0.47 to 2.26) |
| ABC | 1.12 (0.42 to 3.01) | 0.95 (0.34 to 2.67) |
| NNRTI | ||
| EFV | 1 | 1 |
| NVP | 1.25 (0.76 to 2.07) | 1.42 (0.65 to 3.13) |
| Phone availability | ||
| No | 1 | 1 |
| Yes | 0.80 (0.57 to 1.12) | 1.10 (0.76 to 1.60) |
ABC, abacavir; aHR, adjusted hazard ratio; ALT, alanine aminotransferase; AZT, zidovudine; BMI, body mass index; CI, confidence interval; EFV, efavirenz; HR, hazard ratio; NNRTI, non‐nucleoside reverse transcriptase inhibitors; NRTI, nucleoside reverse transcriptase inhibitor; NVP, nevirapine; PHC, primary healthcare level; SHC, secondary healthcare level; SOC, standard of care; TDF, tenofovir disoproxil fumarate; WHO, World Health Organization.
The proportional hazard assumption was satisfied. The flexible parametric model had three internal knots;
period‐1 is the WHO 2010 (from October 2014 to October 2015) and period‐2 is the WHO 2013 (from November 2015 onwards) ART initiation guideline implementation period as followed under standard of care;
secondary healthcare: ART outpatient departments in one health centre (with inpatient capacity) in Treat‐All and ART outpatient departments in one hospital in standard of care;
this is the time from HIV diagnosis to ART initiation;
this is the time from facility‐based HIV care enrolment to ART initiation.