Survival analysis of people living with human immunodeficiency virus: a study in a teaching hospital


  • S. Bhagyabati Devi Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India
  • T. Jeetenkumar Singh Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India
  • Kshetrimayum Birendra Singh Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India
  • N. Biplab Singh Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India
  • Robinson Ningshen Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India
  • Thiyam Brojendro Singh Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India



Antiretroviral therapy, National aids control organization, People living with HIV


Background: Antiretroviral therapy (ART) have changed the outlook of people living with HIV (PLHIV) by transforming the dreaded infection to a chronically manageable disease. However, there is scant of reports which analyses quantitatively the survival benefit of PLHIV under ART. Objectives of this study were to determine the survival time of adult PLHIV who are on ARV. To analyse the factors determining survival outcome of PLHIV on ARV.

Methods: This was an observational study in centre of excellence (COE) ART Centre, RIMS, Imphal from April 2004 to December 2009. Details from the data entered in documents of the ART programme were followed up every 3 months for 60 months from the date of initiation of ARV. All PLHIV above 18 years of age and undergoing antiretroviral therapy were included.

Results: Survival rate following initiation of ARV was found to be significantly high among PLHIV. Higher CD4 count at the time of ARV initiation had better prognosis. Mortality was high among IDUs and they had high incidence of co-infections with HCV and HBV. The currently available ARV drugs under NACO programme have better suppression of HIV, are less toxic, low pill burden. The combined regimen used in the earlier days were not much inferior to the current ARV drugs if initiated timely with proper prophylaxis of OIs, good adherence, good nutrition and timely management of toxicities and IRIS.

Conclusions: Timely treatment with ARV drugs provided under the national programme with good adherence and regular follow-up improves the survival of PLHIV.



Author Biography

S. Bhagyabati Devi, Department of Medicine, RIMS, Imphal and SACEP Members of COE, ART Centre, RIMS, Manipur, India

Medicine department

Rims Imphal Manipur


Kumarasamy N, Solomon S, Flanigan TP, Hemalatha R, Thyagarajan SP, Mayer KH. Natural history of human immunodeficiency virus disease in southern India. Clin Infect Dis. 2003;36(1):79-85.

HIV and AIDS in India. Available at: Accessed on 12th May 2020.

Socio-economic impact of HIV and AIDS in Manipur study done by NCAR/NACO/UNDP in 2004-5. 2006.

UNAIDS Fact sheet, 2018; Available at: Accessed on 14th May 2020.

National AIDS Control Organisation Annual Report 2015-16. Available at: Accessed on 14th May 2020.

Egger M, Hirschel B, Francioli P, Sudre P, Wirz M, Flepp M, et al. Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study. BMJ. 1997;315(7117):1194-9.

Wanyeki I, Cole D, Sills G, Bass P. Five year survival probabilities after ART start at 3 hospitals in Guyana. In Proceedings of the Caribbean HIV Conference. Nassau, The Bahamas. 2011.

UNAIDS/WHO, AIDS epidemic update. 2007. Available at: http:/data slides/20017/2017- epiupdate. Accessed on 14th May 2020.

FMOH, Guidelines for use of antiretroviral drugs in Ethiopia, 2005. Available at: Accessed on 17th May 2020.

Mageda K, Leyna GH, Mmbaga EJ. High Initial HIV/AIDS-related mortality and-its predictors among patients on antiretroviral therapy in the Kagera Region of Tanzania: a five-year retrospective cohort study. AIDS Res Treat. 2012;2012.

Zhang G, Gong Y, Wang Q, Deng L, Zhang S, Liao Q, et al. Outcomes and factors associated with survival of patients with HIV/AIDS initiating antiretroviral treatment in Liangshan Prefecture, southwest of China: a retrospective cohort study from 2005 to 2013. Med. 2016;95(27):e3969.

Setegn T, Takele A, Gizaw T, Nigatu D, Haile D. Predictors of mortality among adult antiretroviral therapy users in southeastern Ethiopia: retrospective cohort study. AIDS Res Treat. 2015;2015.

Alencar WK, Duarte PS, Waldman EA. Survival analysis of acquired immune deficiency syndrome patients with and without hepatitis C virus infection at a reference center for sexually transmitted diseases/acquired immune deficiency syndrome in Sao Paulo, Brazil. The Brazilian J Infect Dis. 2014;18(2):150-7.

Sulkowski MS. Current management of hepatitis C virus infection in patients with HIV co-infection. J Infect Dis. 2013;207(suppl_1):S26-32.

Kumarasamy N, Venkatesh KK, Devaleenol B, Poongulali S, Yephthomi T, Pradeep A, et al. Factors associated with mortality among HIV-infected patients in the era of highly active antiretroviral therapy in southern India. Int J Infect Dis. 2010 Feb 1;14(2):e127-31.

Bhatta L, Klouman E, Deuba K, Shrestha R, Karki DK, Ekstrom AM, et al. Survival on antiretroviral treatment among adult HIV-infected patients in Nepal: a retrospective cohort study in far-western Region, 2006-2011. BMC Infect Dis. 2013;13(1):604.

Bussmann H, Wester CW, Ndwapi N, Grundmann N, Gaolathe T, Puvimanasinghe J, et al. Five year outcomes of initial patients treated in Botswana’s National antiretroviral treatment program. AIDS (London, England). 2008;22(17):2303.

Farahani M, Vable A, Lebelonyane R, Seipone K, Anderson M, Avalos A, et al. Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis. Lancet Global Health. 2014;2(1):e44-50.

Abebe TW, Chaka TE, Misgana GM, Adlo AM. Determinants of survival among adults on antiretroviral therapy in Adama Hospital Medical College, Oromia Regional state, Ethiopia. J HIV AIDS. 2016;2(1):1-6.

Mengesha S, Belayihun B, Kumie A. Predictors of survival in HIV-infected patient after Initiation of HAART in Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Int Scholarly Res Notices. 2014;2014.

Workneh N, Germa T, Woldie M. Immunologic and clinical outcomes of children on HAART: a retrospective cohort analysis at Jimma University Specialised Hospital. Ethiopian J Health Sci. 2009;19(2):75-82.

Hasse B, Ledergerber B, Furrer H, Battegay M, Hirschel B, Cavassini M, et al. Swiss HIV cohort study. Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis. 2011;53(11):1130-9.

Amuron B, Levin J, Birunghi J, Namara G, Coutinho A, Grosskurth H, Jaffar S. Mortality in an antiretroviral therapy programme in Jinja, south-east Uganda: a prospective cohort study. AIDS Res Therapy. 2011;8(1):39.

Bachani D, Garg R, Rewari BB, Hegg L, Rajasekaran S, Deshpande A, et al. Two-year treatment outcomes of patients entolled in India's national first-line antiretrovital therapy programme. National Medical Journal of India. 2010;23(1):7.

Trickey A, May MT, Vehreschild JJ, Obel N, Gill MJ, Crane HM, et al. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. The lancet HIV. 2017;4(8):e349-56.






Original Research Articles