Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia

Galana Mamo Ayana,1 Temesgen Yihunie Akalu,2 Tadesse Awoke Ayele2 1Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, EthiopiaCorresponde...

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Autores principales:	Ayana GM, Akalu TY, Ayele TA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	tb incidence viral load change joint modeling adults hiv/aids Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/6a70772615e84732b409a7a42603ff8d
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spelling	oai:doaj.org-article:6a70772615e84732b409a7a42603ff8d2021-12-02T13:39:18ZJoint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia1179-1373https://doaj.org/article/6a70772615e84732b409a7a42603ff8d2021-03-01T00:00:00Zhttps://www.dovepress.com/joint-modeling-of-incidence-of-tuberculosis-and-change-in-viral-load-o-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Galana Mamo Ayana,1 Temesgen Yihunie Akalu,2 Tadesse Awoke Ayele2 1Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, EthiopiaCorrespondence: Temesgen Yihunie Akalu Email temesgenyihunie@gmail.comBackground: Globally, approximately 37.9 million people were living with HIV and one-third of these people are co-infected with tuberculosis (TB). However, little is known about predictors of tuberculosis incidence and its association with viral load. Thus, this study was aimed at assessing the incidence of tuberculosis and its predictors and its association with the longitudinal change in viral load over time among adult HIV/AIDS patients at Zewditu memorial hospital, Addis Ababa Ethiopia.Methods: A retrospective follow-up study was conducted among 471 HIV patients. The proportional hazard assumption was checked for the survival sub-model and the longitudinal sub-model. &Ngr;ormality assumption was checked. Then the joint model with time-dependent lagged parameterizations was fitted. The goodness of fit was checked using the Cox-Snell residual test and Akaike Information Criteria (AIC) was used for model selection. Finally, the hazard ratio with a 95% confidence interval (CI) with a corresponding P-value < 0.05 was used.Results: A total of 471 patients were followed for a minimum of 12 and a maximum of 48 months with a median follow-up time of 44 months [IQR (33, 46)]. The incidence rate was 3.08/1000 person-years (PY) with a 95% CI of [0.0023788, 0.003998). Age above 65 years adjusted hazard ratio (AHR) = 2.07, 95% CI: 1.06, 4.06), underweight at baseline (AHR = 2.29, 95% CI: 1.20, 4.35), past opportunistic infection (AHR = 2.98, CI: 1.23, 7.17) and 6th month lagged value of the viral load were significant predictors for being co-infected with TB.Conclusion: The incidence of TB among HIV/AIDS patients in Zewditu memorial hospital was low. Older age, underweight at baseline, and past opportunistic infection were significant predictors of time to TB co-infection. Thus, addressing significant predictors and strengthening continuous follow-up are highly recommended in the study setting.Keywords: TB incidence, viral load change, joint modeling, adults, HIV/AIDSAyana GMAkalu TYAyele TADove Medical Pressarticletb incidenceviral load changejoint modelingadultshiv/aidsImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 13, Pp 239-249 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tb incidence viral load change joint modeling adults hiv/aids Immunologic diseases. Allergy RC581-607
spellingShingle	tb incidence viral load change joint modeling adults hiv/aids Immunologic diseases. Allergy RC581-607 Ayana GM Akalu TY Ayele TA Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
description	Galana Mamo Ayana,1 Temesgen Yihunie Akalu,2 Tadesse Awoke Ayele2 1Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, EthiopiaCorrespondence: Temesgen Yihunie Akalu Email temesgenyihunie@gmail.comBackground: Globally, approximately 37.9 million people were living with HIV and one-third of these people are co-infected with tuberculosis (TB). However, little is known about predictors of tuberculosis incidence and its association with viral load. Thus, this study was aimed at assessing the incidence of tuberculosis and its predictors and its association with the longitudinal change in viral load over time among adult HIV/AIDS patients at Zewditu memorial hospital, Addis Ababa Ethiopia.Methods: A retrospective follow-up study was conducted among 471 HIV patients. The proportional hazard assumption was checked for the survival sub-model and the longitudinal sub-model. &Ngr;ormality assumption was checked. Then the joint model with time-dependent lagged parameterizations was fitted. The goodness of fit was checked using the Cox-Snell residual test and Akaike Information Criteria (AIC) was used for model selection. Finally, the hazard ratio with a 95% confidence interval (CI) with a corresponding P-value < 0.05 was used.Results: A total of 471 patients were followed for a minimum of 12 and a maximum of 48 months with a median follow-up time of 44 months [IQR (33, 46)]. The incidence rate was 3.08/1000 person-years (PY) with a 95% CI of [0.0023788, 0.003998). Age above 65 years adjusted hazard ratio (AHR) = 2.07, 95% CI: 1.06, 4.06), underweight at baseline (AHR = 2.29, 95% CI: 1.20, 4.35), past opportunistic infection (AHR = 2.98, CI: 1.23, 7.17) and 6th month lagged value of the viral load were significant predictors for being co-infected with TB.Conclusion: The incidence of TB among HIV/AIDS patients in Zewditu memorial hospital was low. Older age, underweight at baseline, and past opportunistic infection were significant predictors of time to TB co-infection. Thus, addressing significant predictors and strengthening continuous follow-up are highly recommended in the study setting.Keywords: TB incidence, viral load change, joint modeling, adults, HIV/AIDS
format	article
author	Ayana GM Akalu TY Ayele TA
author_facet	Ayana GM Akalu TY Ayele TA
author_sort	Ayana GM
title	Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
title_short	Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
title_full	Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
title_fullStr	Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
title_full_unstemmed	Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
title_sort	joint modeling of incidence of tuberculosis and change in viral load over time among adult hiv/aids patients on anti-retroviral therapy at zewditu memorial hospital in addis ababa, ethiopia
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/6a70772615e84732b409a7a42603ff8d
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Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia

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