Incidence And Predictors Of Opportunistic Infection Among People Living With Human Immunovirus After Initiation Of Highly Active Antiretroviral Therapy At Art Sites Of Public Health Facilities In Horo Guduru Wollega, Oromia,2025

Abstract

Background: Opportunistic infections (OIs) are illnesses that attack people with weakened immune system such as HIV positives. The majority of OIs are the leading causes of morbidity and mortality among PLHIV in low- and middle-income country. Objective; To assess the incidence and predictors of opportunistic infections in HIV infected people after initiation of HAART in public health facilities of Horo Guduru Wollega zone, Oromia, Ethiopia, 2025. Methods: Facility based retrospective cohort study was used. The records of 304 ART clients who initiated HAART between Jan.1, 2019 and Dec.31, 2023 were selected using simple random sampling technique. Data were collected by reviewing ART registration log book and entered to Epi data version 3.1 and imported to SPSS 26 for analysis. Kaplan–Meier curve was used to estimate the survival function and Hazard function after HAART initiation and Cox proportional hazard regression model was used to identify predictor of Opportunistic infection. An adjusted hazard ratio (AHR) with 95% CI was used to identify significant predictor of Opportunistic infections. The statistical significance was declared at p-value <0.05. Result: The 304 study participants were followed for 60 months with a total 7818 person- months observation, 210 (61.95%) censored and 94 (30.9%) experienced Opportunistic Infections with an overall incidence rate of 12.02% (95% CI: 10.8–15.6) per1000 person-months of observation. Urban residents (AHR 1.90, 95% CI (1.24- 2.90). hemoglobin <10gm/dl (AHR 1.55, 95% CI (1.011-2.38), Bed ridden function s (AHR 2.22,95%CI. (1.24-3.97) and Ambulatory function status (AHR 2.14(1.32-3.46).Poor ART adherence (AHR 2.91(1.68-5.02) and comorbidity (AHR= 1.80; 95% CI 1.04–3.11 were potential predictors of opportunistic infection. Conclusion and Recommendation: This study results indicate that the incidence rate of Opportunistic Infection was 12.02 per1000 person-months of observation Being bedridden, poor adherence, <10mg/dl hemoglobin level and comorbidity are significantly associated with incidence of Opportunistic infections among PLHIV