Back ground: Time-to-lost follow-up and CD4 cell variation measures are the outcome variables of infection in HIV/AIDS patients after starting ART in this study. The time-to-lost follow-up from ART was determined by month time interval among dates of ART commencement to drop-out, as documented by the health information data administrator. The main goal of this study was to identify association of CD4 cell variation measurements on time-to-lost follow-up and main predictors of HIV/AIDS positive patients.
Methods: Institution based retrospective cohort study design was used among 216 HIV/AIDS patients under ART follow-up from period September 11, 2013 to September 5, 2016 at Mekelle General Hospital, Ethiopia and employed both survival and longitudinal outcome to fit separate and statistical joint modeling approach.
Results: A total of 216 HIV/AIDS patients were selected using systematic random sampling technique to analyze the longitudinal and survival outcome using joint model study. The result of this study showed that relationship between CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant. Thus, time-to-lost follow-up from ART is less probable to occur in HIV/AIDS patients which have higher CD4 cell evolution. In survival sub-model Baseline CD4, sex of male, living in rural and comorbidity HIV/TB were significant factors of risk to time-to-lost follow-up from ART of HIV/AIDS patients. The longitudinal sub-model shows Baseline CD4 cell and being bedridden were significant factors of variation at 5% significance levels.
Conclusions: The author assessed relationship of repeated measured CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant and performance of both separate and statistical joint sub-models in terms model parsimony, smaller AIC & smaller standard error in statistical joint model performs. Thus, the author concluded that statistical joint model was preferred for simultaneous analyses of repeated biomarker CD4 cell and survival time-to-lost follow-up data.