Long-Term Survival and Predictors of Mortality among Adults Living with HIV Receiving Combination Antiretroviral Therapy in Oman: An Ambidirectional Cohort Study, 1992-2024

Long-Term Survival and Predictors of Mortality among Adults Living with HIV Receiving Combination Antiretroviral Therapy in Oman: An Ambidirectional Cohort Study, 1992-2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Long-Term Survival and Predictors of Mortality among Adults Living with HIV Receiving Combination Antiretroviral Therapy in Oman: An Ambidirectional Cohort Study, 1992-2024 Zainab M. Al-Zadjali, Faryal Khamis, Amal Malehi, Sanjay Jaju, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9490985/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Acquired immunodeficiency syndrome (AIDS) remains a major global public health challenge despite substantial advances in combination antiretroviral therapy (cART). Understanding factors associated with mortality among people living with HIV/AIDS (PLWH) receiving cART is essential, particularly in settings such as Oman, where long-term epidemiological data remain limited. This study aimed to evaluate long-term survival and identify predictors of mortality among PLWH receiving cART in Oman over 32 years. Methods An ambidirectional cohort study was conducted using data from the HIV/AIDS registry at the national tertiary referral hospital, the Royal Hospital in Oman, covering the period from January 1992 to December 2024. A total of 549 adult PLWH receiving cART were included. Clinical and laboratory data were extracted from electronic medical records and analyzed using descriptive statistics, Kaplan-Meier survival analysis, and multivariable Cox proportional hazards regression. Results Out of 549 individuals diagnosed with HIV/AIDS in Oman, 99 deaths were recorded. Of these, 83 deaths were due to AIDS-related causes, while 16 were due to other reasons. The overall incidence rate of deaths was 1.5 per 1,000 person-months (95% CI: [1.21, 1.80]). In the adjusted Cox model, patients aged 18 to 27 (adjusted hazard ratio (AHR) = 0.37, 95% CI: [0.16, 0.84]) and those aged 28 to 37 (AHR = 0.31, 95% CI: [0.15, 0.63]) exhibited a significantly lower hazard of mortality compared to individuals aged 48 and older. Additionally, patients in WHO stage 1 (AHR = 0.23, 95% CI: [0.09, 0.58]), stage 2 (AHR = 0.23, 95% CI: [0.06, 0.86]), and stage 3 (AHR = 0.39, 95% CI: [0.23, 0.64]) faced a reduced mortality risk in comparison to those with severe symptoms or stage 4. Low hemoglobin levels (< 10 g/dL) were associated with increased mortality (AHR = 1.75, 95% CI: [1.09, 2.81]). Conclusion The overall mortality incidence rate was 1.5 per 1,000 person months. Younger age, earlier clinical stage at diagnosis, and normal hemoglobin levels were associated with improved survival among people living with HIV/AIDS receiving combination antiretroviral therapy in Oman. These findings emphasize the importance of early diagnosis, timely treatment initiation, and strengthened national HIV programs to reduce HIV/AIDS related mortality. HIV AIDS Mortality Survival Analysis Cox-Proportional Hazards Model Cohort Oman Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 1. Background Human immunodeficiency virus (HIV) infection continues to pose a major global public health challenge. Since the beginning of the epidemic in 1981, approximately 91.4 million people (range: 73.4 to 116.4 million) have been infected with the virus, and around 44.1 million (37.6 to 53.4 million) have died from AIDS-related illnesses (UNAIDS, 2024). HIV/AIDS remains a leading cause of morbidity and mortality, particularly in low- and middle-income countries (Kusumaadhi et al., 2021). In 2024 alone, approximately 1.3 million people (1.0 to 1.7 million) became newly infected with HIV, underscoring ongoing transmission risk (UNAIDS, 2024). The introduction of combined antiretroviral therapy (cART), has transformed HIV from a fatal diagnosis to a manageable chronic condition (Alwahibia et al., 2025). As a result, people living with HIV (PLWH) now often experience life expectancies that approach those of individuals without HIV (Alwahibia et al., 2025). Notably, about 31.6 million individuals (27.8–32.9 million) were receiving ART in 2024 (UNAIDS, 2024). Survival among PLWH is typically defined as the time from initiation of cART to outcomes such as mortality, loss to follow-up, or retention in care. Survival outcomes vary significantly by region and are influenced by a range of individual-level factors (Kebede et al., 2020). The global burden of HIV-related mortality rose steadily between 1990 and 2005, peaking at 1.9 million deaths in 2005, before declining to 680,000 in 2021 and further to an estimated 630,000 deaths in both 2023 and 2024 (Awaidy et al., 2023; UNAIDS, 2023, 2024). During this period, the HIV-related mortality rate in the United States and its territories was 1.6 per 100 persons aged 13 and older with diagnosed HIV, with the highest rates observed in Southern states (CDC, 2025). In Ethiopia, the HIV-related mortality rate was reported at 4.2 per 100 person-years (equivalent to 3.5 deaths per 1,000 person-months), with major risk factors including older age, poor adherence to cART, tuberculosis (TB) co-infection, non-disclosure of HIV status, being bedridden at presentation, and severe anaemia (Kebede et al., 2020). Similarly, a study in Indonesia identified male sex, age ≥ 45 years, advanced WHO clinical stage (III/IV), low CD4 count (≤ 200 cells/mm³), poor treatment adherence, TB co-infection, and anaemia as significant predictors of mortality (Kusumaadhi et al., 2021). Contrary to the global trend, the burden of HIV/AIDS-related mortality has increased in parts of the Eastern Mediterranean Region (EMR) (GBD 2015 Eastern Mediterranean Region HIV/AIDS Collaborators, 2018). In the Middle East and North Africa (MENA), mortality peaked at 11,000 deaths in 2013, before falling to 7,900 by 2020 (Elgalib et al., 2020). In 2021, Saudi Arabia recorded over 200 HIV-related deaths, while Qatar and United Arab Emirates (UAE) each reported fewer than 100, while reliable mortality data for Kuwait remain limited (Awaidy et al., 2023; UNAIDS, 2023). These regional variations highlight the persistent inequities in access to prevention, diagnosis, and care across global contexts, despite overall improvements in HIV control. In Oman, approximately 2,800 people were living with HIV in 2023 (Alwahibia et al., 2025). A local retrospective study reported an average survival time of 8.5 years (102 months) among PLWH, with 44% (689 of 1,566) surviving beyond eight years (Elgalib et al., 2020). The study also highlighted a sex disparity in mortality: by December 2018, 40.3% of diagnosed females had died, compared to 52.1% (1,152 of 2,212) of males. Despite these insights, the factors influencing long-term survival among HIV-positive individuals receiving cART in Oman remain poorly understood. Existing research has largely focused on prevalence and treatment outcomes, relying primarily on cross-sectional designs that limit causal inference (Elgalib et al., 2020; Karbasi et al., 2023). Given these gaps, this study aimed to explore survival outcomes and identify predictors of mortality among adults living with HIV at the national tertiary referral center, Royal Hospital. This study offers valuable insights for national HIV care programs by enhancing the understanding of long-term survival patterns and informing targeted interventions aimed at reducing mortality. The findings may support evidence-based decision-making to optimize care delivery and resource allocation in Oman. 2. Methods 2.1 Study Aim The primary aim of this study was to examine long-term survival and identify predictors of mortality among adults living with HIV receiving cART in Oman over 32 years (1992–2024). 2.2 Study Design This ambidirectional cohort study utilized data from the national HIV/AIDS registry at the Royal Hospital, Oman. The study incorporated retrospective data from 1 January 1992 to 26 August 2024 and prospective data collected between 27 August and 31 December 2024, resulting in an overall observation period of January 1992 to December 2024. 2.2 Study Setting The study was conducted at the Royal Hospital in Muscat, Oman, the national tertiary referral center for HIV care. The hospital provides specialized management of complex HIV cases under infectious disease specialists and maintains a national registry for clinical follow-up and treatment monitoring. The facility has a large inpatient capacity and serves as a referral center for HIV care across the country (Royal Hospital- MOH, 2026). 2.3 Participants (Inclusion and Exclusion Criteria) The study population consisted of adults aged ≥ 18 years diagnosed with HIV infection and receiving care at the Royal Hospital who initiated cART during the study period. HIV infection was confirmed using the national diagnostic algorithm, including Western blot and other confirmatory assays.Participants were included if they had complete baseline laboratory data for CD4 cell count, viral load, and hemoglobin levels. Individuals with incomplete baseline clinical or laboratory data required for survival analysis were excluded to ensure data integrity and minimize information bias. 2.4 Data Sources and Data Collection Data were extracted from the Al-Shifa 3 + electronic health record system using a structured Excel-based checklist. Retrospective data for patients diagnosed between 1992 and 26 August 2024 were retrieved from the electronic registry. From 27 August 2024 onward, prospective follow-up data were collected to update clinical outcomes and treatment information. The study relied entirely on routinely recorded hospital registry data, with no direct participant contact or interviews conducted. 2.5 Study Variables The study collected sociodemographic, clinical, and laboratory variables. Socio-demographic variables included age at diagnosis, sex, marital status, and employment status. Clinical variables included mode of HIV transmission, comorbidities, WHO clinical stage at diagnosis, cART initiation date, cotrimoxazole prophylaxis use, treatment adherence, and reported cART-related adverse effects. WHO clinical stage at diagnosis was classified according to the World Health Organization HIV clinical staging guidelines as Stage 1 (asymptomatic), Stage 2 (mild symptoms), Stage 3 (advanced symptoms), and Stage 4 (severe symptoms/AIDS) (Twabi et al., 2026). Laboratory variables included baseline CD4 cell count, viral load, and hemoglobin level, with 10 g/dL used as the cut-off value. 2 . 5.1 Outcome Definition The primary outcome was all-cause mortality among adults living with HIV receiving cART at the Royal Hospital, classified as a binary outcome (mortality vs. censored non-mortality). Death events were identified through hospital medical records and routine follow-up documented in the Al-Shifa 3 + electronic system (Shifa3+). Time-to-event was defined as the interval between HIV diagnosis and the date of death. Participants who were alive at the end of follow-up or lost to follow-up were classified as censored non-mortality observations, with follow-up ending on 31 December 2024 (Gomes et al., 2026). Survival analyses, including Cox proportional hazards regression, were conducted to assess factors associated with mortality while accounting for censored non-mortality outcomes (Gomes et al., 2026). 2.6 Bias Considerations Observational cohort studies are susceptible to several sources of bias, including selection bias, information bias, misclassification bias, and immortal time bias (Aschengrau & Seage, 2020). Selection bias was addressed by eligible patients from the national HIV registry and applying consistent inclusion criteria since the selection bias occurs when the study sample differs systematically from the target population (Aschengrau & Seage, 2020). In this study, selection bias was minimized by including all eligible adults recorded in the national HIV registry in Oman between 1992 and 2024 with complete baseline clinical and laboratory data and by applying consistent inclusion and exclusion criteria. Information bias arises from systematic errors in the measurement of exposures, covariates, or outcomes (Aschengrau & Seage, 2020).This risk was reduced through the use of standardized electronic medical records from the Al Shifa 3 + system, which minimized reliance on patient recall. Misclassification bias, a subtype of information bias, occurs when participants are incorrectly categorized with respect to exposures or outcomes (Aschengrau & Seage, 2020). This was limited by applying the WHO HIV clinical staging guidelines for disease classification and predefined laboratory thresholds (Twabi et al., 2026). Immortal time bias can occur in time-to-event analyses when periods of guaranteed survival are misclassified, potentially overestimating survival (Huang et al., 2025). In this study (January 1992-31 December 2024), follow-up was defined from HIV diagnosis until death or study end, and Kaplan-Meier and Cox regression accounted for censoring and loss to follow-up, reducing attrition bias (Bekele et al., 2024; Dudley et al., 2016). 2.7 Sample Size Calculation The required sample size was calculated using OpenEpi version 3.01, assuming a 95% confidence level, 5% significance level, and 80% power (Hajian-Tilaki, 2014). Estimation was based on a previous study involving 1,245 patients with documented CD4 counts from 1984 to 2018, in which 59.3% of the non-exposed group had CD4 counts > 200 cells/mm³ and 40.7% of the exposed group had CD4 counts < 200 cells/mm³ (Elgalib et al., 2020). 2.8 Sampling Method A total of 549 patients were included from the Royal Hospital HIV registry using a convenience sampling technique. As the Royal Hospital serves as the national referral center for HIV care in Oman, the registry includes patients from across the country, enhancing representativeness. Although convenience sampling can theoretically limit generalizability, the national scope of the hospital supports reasonable external validity of the findings (Andrade, 2021; Wang et al., 2016; Zrineh et al., 2026). 2.9 Data Analysis Statistical analyses were performed using IBM SPSS Statistics (Version 27). Categorical variables were summarized as frequencies and percentages, and group differences were assessed using chi-square tests (Kaliyadan & Kulkarni, 2019). Kaplan-Meier survival analysis was used to estimate survival probabilities and time to mortality among people living with HIV (PLWH) (Dudley et al., 2016). Mortality incidence rates were calculated per 1,000 person-months of follow-up. Survival time was measured in months from the date of HIV diagnosis to the date of mortality (Aschengrau & Seage, 2020). Participants alive at the end of follow-up or lost to follow-up were treated as right-censored observations at their last clinical visit (Beis et al., 2024; Gebre et al., 2025; Prinja et al., 2010). Cox proportional hazards regression was applied to identify predictors of mortality while adjusting for potential confounders (Gomes et al., 2026). All variables were entered simultaneously using the enter method in the Cox model. Results were reported as crude hazard ratios (HRs) and adjusted hazard ratios (AHRs) with 95% confidence intervals, with P ≤ 0.05 considered statistically significant. The proportional hazards assumption for the Cox regression model was evaluated using log-minus-log survival plots and statistical diagnostics, and no violation of the proportional hazards assumption was observed. 3. Results 3.1 Socio-demographic characteristics of people living with HIV (PLWH) Table 1 presents the socio-demographic profile of 549 individuals diagnosed with HIV in Oman, classified by patient status: death (n = 99) and censored (alive or lost to follow-up; n = 450). Deaths were notably higher among males, who comprised 80.8% (n = 80) of the deaths (p = 0.005). Age also exhibits a significant difference (p = 0.002); patients aged 28 to 37 accounted for a larger proportion of deaths (27.3%, n = 27) compared to the other three age groups. The year of diagnosis shows a significant association (p = 0.001), with those diagnosed in 2008 or earlier experienced the highest proportion of deaths (45.5%, n = 45) relative to those diagnosed in subsequent years. Marital status is also significantly related to survival (p = 0.003), as deaths were more common among married individuals (48.5%, n = 48). Additionally, deaths were higher among those who were unemployed (55.6%, n = 55) (p = 0.001). Table 1 Socio-demographic characteristics of HIV/AIDS patients, stratified by patients’ status (mortality and censored), in Oman from 1992 to 2024. Characteristics Total Mortality Censored P-value (n = 549) (n = 99) (n = 450) Variables n(%) n (%) n (%) Sex 0.005* Male 379 (69.0) 80 (80.8) 299 (66.4) Female 170 (31.0) 19 (19.2) 151 (33.6) Nationality 0.339 Omani 530 (96.5) 94 (94.9) 436 (96.9) Non-Omani 19 (3.5) 5 (5.1) 14 (3.1) Age (years) 0.002* 18 to 27 142 (26.6) 21 (21.2) 125 (27.8) 28 to 37 206 (37.5) 27 (27.3) 179 (39.8) 38 to 47 116 (21.1) 26 (26.3) 90 (20.0) 48 or above 81 (14.8) 25 (25.3) 56 (12.4) Years of diagnosis 0.001* 2008 or earlier 142 (25.9) 45 (45.5) 97 (21.6) 2009 to 2014 147 (26.8) 31 (31.3) 116 (25.8) 2015 to 2019 142 (25.9) 15 (15.2) 127 (28.2) 2024 or later 118 (21.5) 8 (8.1) 110 (24.4) Marital status 0.003* Not disclosed 16 (2.9) 8 (8.1) 8 (1.8) Single 194 (35.3) 39 (39.4) 155 (34.4) Married 287 (52.3) 48 (48.5) 239 (53.1) Divorced 31 (5.6) 2 (2.0) 29 (6.4) Widow 21 (3.8) 2 (2.0) 19 (4.2) Employment 0.001* Not disclosed 44 (8.0) 17 (17.2) 27 (6.0) Employed 251 (45.7) 27 (27.3) 224 (49.8) Unemployed 254 (46.3) 55 (55.6) 199 (44.2) * Significant p-value ≤ 0.05. 3.2 Clinical characteristics of people living with HIV Table 2 presents a summary of the clinical characteristics of 549 individuals living with HIV, comparing those who died (n = 99) to those who were censored (n = 450). The mode of transmission was found to be significantly associated with mortality (p = 0.001). Nearly half of the deceased patients had an unknown transmission route (48.5%, n = 48), followed by sexual transmission (40.4%, n = 40). The reason for HIV testing also demonstrated a strong association with outcomes (p = 0.001), as most patients who died had been diagnosed after presenting HIV-related symptoms (85.9%, n = 85). WHO clinical staging emerged as a significant predictor of survival (p = 0.001), with severe symptoms (stage 4 or AIDS) reported in 60.6% (n = 60) of those who died. Deaths also differed significantly by comorbidity status (p = 0.001), with a higher prevalence of patients without comorbidities among those who died (34.3%, n = 34). Notably, the incidence of cancer (23.2%, n = 23) and renal disease (10.1%, n = 10) was disproportionately higher among deceased patients compared to their censored counterparts. Timely initiation of cART was observed in 77.8% (n = 77) of mortality cases, contrasting with 22.2% (n = 22) who delayed treatment. Additionally, deaths were more frequent among those with a hemoglobin level above 10 g/dL (55.5%, n = 55) compared to those with 10 g/dL or lower (44.4%, n = 44) (p = 0.001). Table 2 Clinical characteristics of HIV/AIDS patients, stratified by patients’ status (mortality and censored), in Oman from 1992 to 2024. Characteristics Total Mortality Censored P-value (n = 549) (n = 99) (n = 450) Variables n (%) n (%) n(%) Mode of Transmission Not disclosed 131 (23.9) 48 (48.5) 83 (18.4) 0.001* Sexual 359 (65.4) 40 (40.4) 319 (70.9) Vertical 7 (1.3) 0 (0.0) 7 (1.6) Parenteral 52 (9.5) 11 (11.1) 41 (9.1) Reason for HIV Testing 0.001* Not disclosed 6 (1.1) 2 (2.0) 4 (0.9) Antenatal Care 42 (7.7) 1 (1.0) 41 (9.1) Hospital checkup 18 (3.3) 2 (2.0) 16 (3.6) HIV Contact 103 (18.8) 4 (4.0) 99 (22.0) Test Request 15 (2.7) 0 (0.0) 15 (3.3) HIV Symptoms 304 (55.4) 85 (85.9) 219 (48.7) Official Document/Prisoner 61 (11.1) 5 (5.1) 56 (12.4) WHO a clinical Staging 0.001* Stage 1: Asymptomatic 213 (38.8) 8 (8.1) 205 (45.6) Stage 2: Mild symptoms 25 (4.6) 3 (3.0) 22 (4.9) Stage 3: Advanced symptoms 146 (26.6) 28 (28.3) 118 (26.2) Stage 4: Severe symptoms (AIDS) 165 (30.1) 60 (60.6) 105 (23.3) Comorbidity 0.001* No comorbidity 288 (52.5) 34 (34.3) 254 (56.4) Anemia 66 (12.0) 10 (10.1) 56 (12.4) Diabetes Mellitus 34 (6.2) 6 (6.1) 28 (6.2) Hypertension 22 (4.0) 4 (4.0) 18 (4.0) Heart disease 15 (2.7) 4 (4.0) 11 (2.4) Cancer 51 (9.3) 23 (23.2) 28 (6.2) Thyroid disease 9 (1.6) 1 (1.0) 8 (1.8) Renal disease 20 (3.6) 10 (10.1) 10 (2.2) Psychiatric disorder 22 (4.0) 3 (3.0) 19 (4.2) Dyslipidemia 8 (1.5) 0 (0.0) 8 (1.8) Respiratory disease 14 (2.6) 4 (4.0) 10 (2.2) Time cART b initiation 0.001* Timely 496 (90.3) 77 (77.8) 419 (93.1) Deferred (Active TB c ) 53 (9.7) 22 (22.2) 31 (6.9) Haemoglobin 0.001* 10 g/dL or less 128 (23.3) 44 (44.4) 84 (18.7) More than 10 g/dL 421 (76.7) 55 (55.6) 366 (81.3) a WHO: World Health Organization , b cART: Combined Antiretroviral Therapy. c Tuberculosis. * Significant p-value≤.05. 3.3 Co-infection Among people living with HIV Table 3 demonstrates that coinfections were significantly linked to mortality rates among HIV/AIDS patients. Specifically, deaths were more frequently observed among patients without TB infection (57.6%, n = 57.6) compared to those with active TB (23.2%, n = 23). Regarding syphilis infection, deaths were more frequently observed among individuals without documented infection (74.7%, n = 74) (p = 0.001). Similarly, for HCV infection, mortality was more prevalent among those without the infection (73.7%, n = 73) compared to those with positive HCV status (17.2%, n = 17). Table 3 Co-infection in people living with HIV, stratified by patients’ status (mortality and censored), in Oman from 1992 to 2024. Characteristics Total Mortality Censored P-value (n = 549) (n = 99) (n = 450) Variables n (%) n (%) n (%) Tuberculosis 0.001* Unknown/Not done 91 (16.6) 19 (19.2) 72 (16.0) Positive 58 (10.6) 23 (23.2) 35 (7.8) Negative 400 (72.9) 57 (57.6) 343 (76.2) HBsAg a 0.063 Unknown/Not done 18 (3.3) 7 (7.1) 11 (2.4) Positive 32 (5.8) 6 (6.1) 26 (5.8) Negative 499 (90.9) 86 (86.9) 413 (91.8) Syphilis 0.001* Unknown/Not done 50 (9.1) 22 (22.2) 28 (6.2) Positive 36 (6.6) 3 (3.0) 33 (7.3) Negative 463 (84.3) 74 (74.7) 389 (86.4) HCV IgG b 0.007* Unknown/Not done 25 (4.6) 9 (9.1) 16 (3.6) Positive 64 (11.7) 17 (17.2) 47 (10.4) Negative 460 (83.8) 73 (73.7) 387 (86.0) a HBsAg : Hepatitis B surface antigen , b HCV IgG: Hepatitis C IgG antibody, * Significant p-value ≤ 0.05. 3.4 Behavioral risk factors among people living with HIV Table 4 suggests that there was no significant association between behavioral risk factors and mortality. Deaths occurred more frequently among individuals who did not engage in risky behaviors compared to those who were smokers, alcohol users, injection drug users, or individuals who had been imprisoned, with frequencies of n = 23 (23.2%), n = 18 (18.2%), n = 7 (7.1%), and n = 4 (4.0%), respectively. Table 4 Behavioral risk factors of HIV/AIDS patients, stratified by patients’ status (mortality and censored), in Oman from 1992 to 2024. Characteristics Total Mortality Censored P value (n = 549) (n = 99) (n = 450) n(%) n (%) n (%) Smoking status 0.380 Yes 110 (20.0) 23 (23.2) 363 (80.7) No 439 (80.0) 76 (76.8) 87 (19.3) Alcohol Consumption 0.675 Yes 92 (16.8) 18 (18.2) 74 (16.4) No 457 (83.2) 81 (81.8) 376 (83.6) Injection drug users (IDU) 0.754 Yes 35 (6.4) 7 (7.1) 28 (6.2) No 514 (93.6) 92 (92.9) 422 (93.8) Imprisonment 0.368 Yes 17 (3.1) 4 (4.0) 13 (2.9) No 532 (96.9) 95 (96.0) 437 (97.1) * Significant p-value ≤ 0.05. 3.5 Reasons for mortality among people living with HIV Table 5 summarizes data on deaths among 99 HIV cases at the Royal Hospital in Oman, which includes 83 AIDS-related deaths and 16 non-AIDS-related deaths. Among the total cases, 80 (80.8%) were male, with 67 (80.7%) in the AIDS group and 13 (81.3%) in the non-AIDS group. The remaining 19 individuals (19.2%) were female, consisting of 16 (19.3%) in the AIDS group and 3 (18.8%) in the non-AIDS group, indicating a statistically significant difference (P = 0.02). In terms of WHO clinical staging, 60 patients (60.6%) were classified as being in the severe stage (stage 4), with 55 (66.3%) of these deaths being AIDS-related, compared to 5 (31.3%) non-AIDS deaths. Additionally, 28 patients (28.2%) exhibited advanced symptoms (stage 3), including 21 (25.3%) AIDS-related and 7 (43.8%) non-AIDS deaths. There were 8 patients (8.0%) in the asymptomatic category (stage 1), with 5 (6.0%) being AIDS-related and 3 (18.8%) non-AIDS, while 3 (3.0%) had mild symptoms (stage 2), including 2 (2.4%) AIDS-related and 1 (6.3%) non-AIDS. The association between WHO stage and cause of mortality was found to be statistically significant (P = 0.001), with AIDS-related deaths occurring more frequently among patients in the advanced (stage 3) or severe (stage 4) stages. Table 5 Reasons of Mortality among people living with HIV in Oman, (1992–2024). Characteristics Total AIDS Related Mortality Non-AIDS Related Mortality P-value n = 99 n = 83 n = 16 Variables N (%) N (%) N (%) Sex 0.02 * Male 80 (80.8) 67 (80.7) 13 (81.3) Female 19 (19.2) 16 (19.3) 3 (18.8) WHO Clinical Staging 0.001 * Stage 1: Asymptomatic 8 (8.0) 5 (6.0) 3 (18.8) Stage 2: Mild symptoms 3 (3.0) 2 (2.4) 1 (6.3) Stage 3: Advanced symptoms 28 (28.2) 21 (25.3) 7 (43.8) Stage 4: Severe symptoms (AIDS) 60 (60.6) 55 (66.3) 5 (31.3) * Significant p-value ≤ 0.05. 3.6 Mortality Incidence Rate among people living with HIV The overall incidence rate of mortality among People living with HIV (PLWH) in the study was approximately 2 deaths per 1,000 person-months (95% CI: [1.21, 1.80]) during the follow-up period. When analyzed by gender, males exhibited a higher mortality rate of 2 deaths per 1,000 person-months (95% CI: [1.44, 2.25]), in comparison to females, who had an incidence rate of 1 death per 1,000 person-months (95% CI: [0.46, 1.22]). This suggests that male patients faced a greater risk of mortality. Age also revealed a significant pattern: younger patients aged 18–27 had a lower death incidence rate of 1 death per 1,000 person-months (95% CI: [0.6, 1.4]), while those in the age groups of 28–37 and 38–47 had moderately higher rates, averaging around 2 deaths per 1,000 person-months. Notably, patients aged 48 years and older experienced the highest death rate, with 4 deaths per 1,000 person-months (95% CI: [2.2, 5.1]). Table 6 Mortality Incidence Rates by Gender and Age Group (Years) among People Living with HIV in Oman, 1992–2024 Characteristic Cases (Mortality) Person-months Incidence Rate /1000 95% CI a (Lower, Upper) Total 99 65,803 1.5 (1.21,1.80) Sex Male 80 43,396 1.8 (1.44,2.25) Female 19 22,407 0.9 (0.46,1.22) Age group (Years) 18 to 27 21 20,776 1.0 (0.60,1.40) 28 to 37 27 25,105 1.08 (1.00,2.70) 38 to 47 26 13,112 1.98 (1.20,2.80) 48 or more 25 6,810 3.67 (2.20,5.10) a CI: Confidence Intervals, The Mortality incidence rate was calculated by dividing the number of new Mortality cases by the total person-time (in months) and multiplying the result by 1,000 (Aschengrau & Seage, 2020). 3.7 Kaplan-Meier Survival Analysis of people living with HIV in Oman (1992–2024) by Gender and Age Table 7 presents the mean survival times and 95% confidence intervals (CIs) among people living with HIV/AIDS in Oman from 1992 to 2024. The overall mean survival time was 298.7 months (SE = 8.9, 95% CI [281.1, 316.3]). Median survival time was not reached because the cumulative survival probability never fell below 0.50 during the follow-up period. When analyzed by gender, females had a longer mean survival time (326.0 months, SE = 16.2, 95% CI [294.2, 357.8]) compared with males (280.2 months, SE = 10.0, 95% CI [260.6, 299.9]). The log-rank test reported a statistically significant difference between genders (χ² = 7.63, df = 1, p = 0.006), suggesting higher survival probabilities for females throughout the follow-up period. Figure 1 illustrates these differences. Survival also varied by age group. Patients aged 28–37 years had the highest mean survival time (324.4 months, SE = 13.3, 95% CI [298.3, 350.5]), whereas those aged 38–47 years had the lowest (233.9 months, SE = 13.0, 95% CI [208.5, 259.5]). The log-rank test showed significant differences across age groups (χ² = 27.98, df = 3, p < 0.001). Figure 2 shows the Kaplan–Meier curves by age, highlighting differences in survival probabilities over time. Median survival times are not reported for most strata because the cumulative survival probability did not fall below 0.50 during the study period, making median estimation not feasible. Table 7 Kaplan–Meier Survival Estimates and Tests of Equality of Survival Distributions by Gender and Age among People Living with HIV/AIDS in Oman (1992–2024) Characteristic Mean Survival Time, months (SEᵃ) 95% CIᵇ (Lower, Upper) Median Survival Timeᶜ Log-Rank χ² (df), p-value Breslow χ² (df), p-value Tarone–Ware χ² (df), p-value p-value Overall 298.7 (8.9) (281.1, 316.3) Not reached – – – – Gender 7.629 (1), 0.006* 7.749 (1), 0.005* 8.182 (1), 0.004* 0.006* Male 280.2 (10.0) (260.6,299.9) Not reached Female 326.0 (16.2) (294.2,357.8) Not reached Age Group (Years) 27.981 (3), 0.001* 30.800 (3), 0.001* 30.624(3), 0.001* 0.001* 18–27 310.9 (13.4) (284.7, 337.3) Not reached 28–37 324.4 (13.3) (298.3,350.5) Not reached 38–47 233.9 (13.0) (208.5,259.5) Not reached ≥ 48 298.7 (8.9) (281.1,316.3) Not reached a SE: standard error; b CI: confidence interval. Median survival could not be estimated for some strata due to limited events.Median survival could not be estimated for some strata due to limited events. c Median survival time was not reached because more than 50% of patients remained alive at the end of follow-up. 3.8 Factors Associated with the Occurrence of Mortality (Cox Regression) Table 8 shows the results of the adjusted Cox proportional hazards regression analysis of factors associated with mortality among people living with HIV. Age at diagnosis was significantly associated with mortality. Compared with individuals aged ≥ 48 years, those aged 18–27 years (AHR = 0.37, 95% CI: 0.16–0.84) and 28–37 years (AHR = 0.31, 95% CI: 0.15–0.63) had a lower hazard of mortality. The WHO clinical stage at diagnosis was also significantly associated with mortality. Participants diagnosed at stage 1 (asymptomatic) (AHR = 0.23, 95% CI: 0.09–0.58), stage 2 (mild symptoms) (AHR = 0.23, 95% CI: 0.09–0.58), and stage 3 (advanced symptoms) (AHR = 0.39, 95% CI: 0.23–0.64) had lower mortality risk compared with those diagnosed at stage 4 (severe symptoms).In addition, low hemoglobin levels (< 10 g/dL) were associated with increased mortality (AHR = 1.75, 95% CI: 1.09–2.81).. Female patients showed higher survival probabilities and lower cumulative hazard of mortality throughout the follow-up period compared with male patients. Table 8 Multivariable Cox Proportional Hazards modelling of Factors Associated with the occurrence of mortality among People living with HIV (PLWH), Oman, 1992–2024. Variable Crude Model Adjusted Model HR a L95CI b U95CI c p =value AHR d L95CI U95CI p =value Years of diagnosis 2008 or before 4.68 2.29 9.63 0.001 1.22 0.49 3.02 0.661 2009 to 2014 3.11 1.46 6.65 0.003 1.41 0.61 3.27 0.418 2015 to 2019 1.56 0.68 3.57 0.29 1.71 0.48 2.89 0.711 2020 or later 1.00 - - - 1.00 - - - Age at Diagnosis 18 to 27 0.47 0.28 0.78 0.003 0.37 0.16 0.84 0.018* 28 to 37 0.42 0.26 0.69 0.001 0.31 0.15 0.63 0.001* 38 to 47 0.73 0.44 1.20 0.22 0.53 0.27 1.04 0.068 48 or above 1.00 - - - 1.00 - - - Gender Male 1.89 1.19 3.00 0.001 1.56 0.78 3.12 0.201 Female 1.00 - - - 1.00 - - - Employment Employed 0.50 0.34 0.75 0.001 0.59 0.34 1.04 0.072 Unemployed 1.00 - - - 1.00 - - - WHO e clinical staging Stage 1: Asymptomatic 0.10 0.049 0.205 0.001 0.23 0.09 0.58 0.002* Stage 2: Mild symptoms 0.33 0.097 1.12 0.075 0.23 0.06 0.86 0.029* Stage 3: Advanced symptoms 0.53 0.36 0.78 0.001 0.39 0.23 0.64 0.001* Stage 4: Severe symptoms (AIDS) 1.00 - - - 1.00 - - - Reason for Testing Antenatal care 0.29 0.90 2.13 0.223 0.68 0.06 6.77 0.743 Hospital checkup 1.35 0.04 6.30 0.705 2.64 0.45 15.46 0.280 HIV Contact 0.48 0.29 1.58 0.224 0.66 0.15 2.76 0.570 Test Request 0.01 0.15 2.63 0.206 0.01 0.001 2.36 0.974 HIV Symptoms 3.41 0.01 8.93 0.013 1.56 0.58 4.17 0.375 Official Document/Prisoner 1.00 - - - 1.00 - - - Time cART f initiation Timely 0.25 0.19 0.32 0.001 0.96 0.11 9.93 0.964 Deferred (Active TB g ) 1.00 - - - 1.00 - - - Mode of Transmission Genderual 0.52 0.25 1.09 0.085 1.72 0.68 4.30 0.245 Vertical 0.33 0.01 6.31 0.45 0.01 0.001 1.56 0.976 Parenteral 1.00 - - - 1.00 - - - Marital Status Single 2.11 0.55 8.16 0.28 2.16 0.43 10.88 0.131 Married 1.76 0.46 6.75 0.41 2.56 0.57 11.50 0.365 Divorced 0.68 0.10 4.45 0.69 0.38 0.05 2.94 0.195 Widow 1.00 - - - 1.00 - - - Comorbidity No Comorbidity 0.30 0.18 0.50 0.001 0.91 0.49 1.90 0.917 1 Comorbidity 0.55 0.33 0.91 0.019 0.71 0.45 1.70 0.717 2 Comorbidity 0.64 0.37 1.12 0.12 0.88 0.50 2.20 0.880 3 or more comorbidities 1.00 - - - 1.00 - - - Tuberculosis Yes 1.09 0.52 2.30 0.82 1.72 0.18 15.87 0.631 No 1.00 - - - 1.00 - - - HCV IgG i Yes 1.67 1.06 2.64 0.028 0.92 0.43 1.99 0.850 No 1.00 - - - 1.00 - - - Syphilis Yes 0.52 0.17 1.57 0.25 0.51 0.29 1.79 0.299 No 1.00 - - - 1.00 - - - Hemoglobin 10 g/dL or less 2.63 1.86 3.70 0.001 1.75 1.09 2.81 0.019* More than 10 g/dL 1.00 - - - 1.00 - - - a Hazard Ratio; b Lower 95% Confidence Interval; c Upper 95% Confidence Interval; d Adjusted Hazard Ratio; e WHO: World Health Organization; f CART: Combined anti-retroviral treatment; g TB: Tuberculosis. h HBsAg : Hepatitis B surface antigen , i HCV IgG: Hepatitis C IgG antibody. * Significant p-value ≤ 0.05. Figure 3 illustrates that people living with HIV (PLWH) diagnosed at age 48 and above exhibit lower survival probabilities and a higher risk of mortality over time compared to younger age groups. Conversely, patients diagnosed between 18 and 37 years demonstrate notably better survival outcomes throughout the follow-up period. Figure 4 shows that survival decreases with advancing WHO clinical stage. Patients with severe or advanced symptoms had lower survival, while asymptomatic and mildly symptomatic patients showed better outcomes, emphasizing the importance of early diagnosis and treatment. The Cox regression Fig. 5 indicates improved survival among HIV/AIDS patients over time. Patients diagnosed after 2020 demonstrated the highest survival and lowest cumulative hazard, while those diagnosed before 2008 had the poorest outcomes. These findings suggest significant advancements in HIV management and treatment across the study period. The survival and hazard Fig. 6 indicate that patients who initiated cART within the first two weeks of active TB infection had lower survival rates and a higher cumulative hazard compared to those who started treatment promptly. 4. Discussion This study aimed to assess predictors of mortality among adult People living with HIV (PLWH) on cART at the Royal Hospital, Oman, from 1992 to 2024. Over the 32 years, a total of 99 deaths were recorded among adults receiving cART, of whom 19 were female and the remaining 80 were male. 4.1 Incidence rate of Mortality among PLWH The overall mortality incidence rate in our study was 1.5 deaths per 1,000 person-months (95%CI: [1.2, 1.8]) of follow-up of 65,803 person-months. In contrast, a study from British Columbia, Canada, reported 3,401 deaths over 562,150 person-years (equivalent to 6,745.8 units of 1,000 person-months), yielding a much lower incidence rate of approximately 6 deaths per 1,000 person-years ( equivalent to 0.5 deaths per 1,000 person-months) (Eyawo et al., 2017). Additionally, in Ethiopia, a study showed that the overall incidence rate of mortality is 4.6 per 1,000 person-years (which is equivalent to approximately 0.38 deaths per 1,000 person-months). (Teshale & Awoke, 2022). This suggests that the mortality rate observed in our study is substantially higher than that reported in the Ethiopian context and Canada. This difference may be due to variations in patient characteristics, healthcare systems, and timing of cART initiation. 4.2 Incidence Rate of Mortality Among PLWH Based on Gender The mortality incidence rate among males was 1.8 deaths per 1,000 person-months, which showed higher mortality among males than females (0.8 deaths per 1,000 person-months). This disparity may be partly explained by greater opportunities females have for early HIV diagnosis, particularly during pregnancy through routine antenatal screening (Jeong et al., 2016; Rao et al., 2018). Additionally, higher mortality among males may be attributed to behavioral factors such as substance use, which can contribute to delayed diagnosis and poor adherence to cART. This finding aligns with a study conducted in Indonesia showed that mortality is higher among males than females (Kusumaadhi et al., 2021). Similarly, another study done in Northwest Ethipoia also showed that mortality is AHR = 2.4 times higher among males than females (Workie et al., 2021). However, in contrast, another study in Ethiopia showed that mortality is higher among females, N = 172 (63.0%), than males, N = 101 (37.0%) (Teshale & Awoke, 2022). 4.3 Incidence Rate of Mortality Among PLWH Based on Age at Diagnosis Consistent with the findings presented earlier, age at diagnosis showed that the mortality incidence rate was higher among those who aged 48 years and above (3.7/1000 person-month, 95% CI: [2.2, 5.1]) than in younger age groups. This is consistent with previous studies showing that mortality risk is higher in older age groups (Kebede et al., 2020; Kusumaadhi et al., 2021; Teshale & Awoke, 2022). In the U.S, for instance, 30% of deaths occurred among those aged 55 to 64 years in 2023 (CDC, 2025). This may be due to stronger immune systems and better response to treatment in younger individuals, as well as fewer comorbid conditions compared to older patients. In addition, it is well established that as age increases, immune status becomes incompetent, which is considered to be a risk for many chronic diseases (Lee et al., 2022; Vassallo et al., 2025) (Lee et al., 2022) and age-related thymic involution and declining immune function, which accelerate HIV progression and increase mortality risk (Goyani et al., 2024; Thomas et al., 2020). The European Study in Infections among Adults (EuroSIDA) study, which followed PLWH from 2001 to 2020, reported that the overall mortality declined over time due to improved cART coverage and care standards; age remained a strong independent risk factor (Kraef et al., 2024). 4.4 Association of Age at Diagnosis with Mortality Among HIV/AIDS Patients Consistent with the findings above, age at diagnosis also significantly influenced survival. Patients diagnosed at a younger age, especially those aged 18–27 and 28–37 years, had a lower risk of mortality compared to those aged 48 and above. Similar to previous studies, mortality risk was higher in older age groups (Bajpai et al., 2014; Kebede et al., 2020; Teshale & Awoke, 2022; Uma et al., 2012). This may be due to stronger immune systems and better response to treatment in younger individuals, as well as fewer comorbid conditions compared to older patients (Lee et al., 2022). In addition, it is known that as age increases, immune status becomes incompetent, which is considered to be a risk for many chronic diseases, leading to mortality (Lee et al., 2022; Vassallo et al., 2025). The European Study in Infections among Adults (EuroSIDA) study, which followed PLWH from 2001 to 2020, reported that the overall mortality declined over time due to improved cART coverage and care standards; age remained a strong independent risk factor (Kraef et al., 2024). 4.5 Association of WHO Clinical Staging with Mortality Among HIV/AIDS Patients WHO clinical stage at diagnosis was another strong predictor of mortality. Patients who were asymptomatic (stage 1) or had mild (stage 2) to advanced symptoms (stage 3) at the time of diagnosis had significantly better survival outcomes than those diagnosed at a severe stage. These results emphasize the value of early diagnosis and regular screening programs to identify HIV infections before they progress. Consistent with a previous study conducted in Ethiopia, which showed that individuals with WHO clinical stages 1, 2, and 3 had a better survival time than those with stage 4 (Nigussie et al., 2020). A systematic review and meta-analysis in sub-Saharan Africa also showed that the WHO clinical staging (3–4) is related to a high mortality rate (Haumba et al., 2024). Starting cART immediately after HIV diagnosis can significantly reduce HIV-related morbidity and mortality. Additionally, those with advanced stage need close monitoring during the early treatment phase to assess cART response and detect potential immune reconstitution inflammatory syndrome (Nigussie et al., 2020). 4.6 Association of Low Hemoglobin Level with Mortality Among HIV/AIDS Patients Our study highlighted that hemoglobin levels less than 10 g/dl were 1.97 times were associated with a higher risk of mortality. This association may be attributed to anemia, a common complication among PLWH that often indicates an advanced stage of the disease (WHO, 2015). Consistent with our findings, a study conducted in Ethiopia revealed that severe anemia increases the risk of mortality among PLWH by 4.57 times compared to those with normal hemoglobin levels (Damtew et al., 2015). Furthermore, research in Indonesia demonstrated that the likelihood of mortality is 2.308 times higher for individuals with hemoglobin levels below 10 g/dL (Kusumaadhi et al., 2021). This study provides one of the longest follow-up cohorts of people living with HIV in the region. 4.7 Limitation This study has some limitations. Key variables such as stigma, mental health, education, income, and treatment literacy were not available, limiting analysis of social determinants. Missing follow-up and clinical data for a small number of patients may have introduced minor bias. Changes in diagnostics and treatment protocols over the 32-year study period may have affected data consistency. Mortality may have been underestimated, particularly among those lost to follow-up, and unmeasured confounding cannot be excluded due to the observational nature of the study. Potential sources of bias were considered during the study design and analysis, as described in the Methods. Selection bias may have arisen from the inclusion of patients with complete baseline data, although efforts were made to include all eligible individuals from the national registry. Information bias and misclassification may be present due to reliance on routinely recorded clinical data; however, the use of standardized electronic medical records and WHO clinical staging criteria likely minimized these effects. In addition, although time-to-event methods were used, residual bias related to the timing of treatment initiation cannot be entirely excluded. These limitations should be considered when interpreting the findings. 5. Conclusion The overall mortality incidence rate among individuals living with HIV/AIDS in Oman receiving combination antiretroviral therapy was 1.5 deaths per 1,000 person-months. Younger age, earlier clinical stage at diagnosis, and hemoglobin levels were significantly associated with survival. These findings highlight the importance of early diagnosis, prompt initiation of treatment, and continuous clinical monitoring to reduce HIV-related mortality. Improving HIV outcomes in Oman requires strengthening early HIV testing strategies, particularly among older adults and high-risk groups, to minimize late-stage diagnoses. Addressing gender disparities in HIV care is also essential, with targeted interventions needed to improve engagement, treatment adherence, and follow-up among male patients. In addition, integrating anemia management into routine HIV care and ensuring timely initiation and sustained adherence to cART may further enhance patient survival and clinical outcomes. Although convenience sampling was employed, the study population was drawn from a national tertiary referral center receiving patients from across Oman, which enhances the representativeness of the cohort. Consequently, the findings may be generalizable to the broader population of PLWH in Oman and may also provide useful insights for HIV programs in other Gulf Cooperation Council (GCC) countries with similar healthcare contexts. Nevertheless, caution should be exercised when extrapolating the findings to populations with different socio-demographic or healthcare characteristics. Abbreviations AIDS Acquired Immune Deficiency Syndrome cART Combined Antiretroviral Therapy CD4 Cluster of Differentiation 4 CI Confidence Interval DM Diabetes Mellitus EuroSIDA European Study in Infections among Adults GCC Gulf Cooperation Council HBsAg Hepatitis B Surface Antigen HCV IgG Hepatitis C IgG Antibody HIV Human Immunodeficiency Virus HTN Hypertension IBM International Business Machines MENA Middle East and North Africa MREC Medical Research Ethics Committee PLWH People Living with HIV RR Relative Risk SPSS Statistical Package for the Social Sciences TB Tuberculosis UAE United Arab Emirates UNAIDS The Joint United Nations Programme on HIV/AIDS WHO World Health Organization Declarations Ethics Approval The study protocol was reviewed and approved by the Scientific Research Committee at the Royal Hospital, Ministry of Health, Oman (Approval No. MoH/CSR/24/28820). All patient data were anonymized, and confidentiality was maintained through de-identification using unique study codes; no personally identifiable information was accessed or disclosed. For the retrospective cohort (1992-26 August 2024), the ethics committee waived the requirement for written informed consent as data were obtained from de-identified hospital records. For the prospective cohort (27 August 2024 to 31 December 2024), patients were followed as part of routine clinical care. Data collection did not involve any direct patient contact or face-to-face interviews; all information was obtained exclusively from hospital electronic records (Shifa3+). Consent for publication Not applicable Availability of data Data is available upon reasonable request from: Dr. Faryal Khamis, Senior Consultant, Deputy Director, Directorate of Medicine, Head of Subspecialties, Royal Hospital, P.O. Box 1331, P.C.111, A’seeb, Oman. E-mail: [email protected] . Competing interests The authors declare no conflict of interest. Funding The authors did not receive any financial support for the research or publication of this article Authors' contributions ZZ, YF, and FK formulated the study concept. ZZ, RA, and JN collected data. ZZ, YF, and RA cleaned data. ZZ and YF contributed to the literature review and manuscript write-up. ZZ, YF, AM, and RA conceptualized the methods. ZZ, YF, AM, RA, SJ, SS, and FK contributed to the review of the results. ZZ, YF, SJ, FK, AM, IM, and KA reviewed the manuscript. All authors read and approved the final manuscript. Acknowledgments The authors would like to thank the Royal Hospital, Ministry of Health, Oman, and University Medical City (Sultan Qaboos University) for their support in conducting this study. 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Socio-demographic profile of HIV/AIDS patients at ART centres in Chennai. BMC Infectious Diseases , 12 (S1), P53, 1471-2334-12-S1-P53. https://doi.org/10.1186/1471-2334-12-S1-P53 UNAIDS. (2023). Global HIV & AIDS statistics. .https://reliefweb.int/report/world/global-hiv-aids-statistics-fact-sheet UNAIDS. (2024). Global AIDS Update 2024. Https://www.unaids.org/en Vaillant, A. A. J., & Gulick, P. G. (2022). HIV disease current practice. Stat Pearls [Internet]: Stat Pearls Publishing. https://www.unaids.org/en Vaillant, A. A. J., & Gulick, P. G. (2022) Vassallo, M., Durant, J., Addou, S., Ticchioni, M., Fabre, R., Chirio, D., Naqvi, A., Cua, E., Ameil, L., Godemert, M., Pradier, C., & Carles, M. (2025). Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV. Frontiers in Medicine , 12 , 1562537. https://doi.org/10.3389/fmed.2025.1562537 Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coates, M. M., Coggeshall, M., Dandona, L., Dicker, D. J., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Foreman, K., Forouzanfar, M. H., Fraser, M. S., … Murray, C. J. L. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet , 388 (10053), 1459–1544. https://doi.org/10.1016/S0140-6736(16)31012-1 WHO. (2015). Maximizing the treatment and prevention potential of antiretroviral drugs: Early country experiences towards implementing a treat-all policy: Programmatic update . JSTOR. Workie, K. L., Birhan, T. Y., & Angaw, D. A. (2021). Predictors of mortality rate among adult HIV-positive patients on antiretroviral therapy in Metema Hospital, Northwest Ethiopia: A retrospective follow-up study. AIDS Research and Therapy , 18 (1), 27. https://doi.org/10.1186/s12981-021-00353-z Zrineh, A., Al‐Usta, M., & Alwawi, A. (2026). Sampling Methods and Sample Size Determination in Clinical Research: An Educational Review. Journal of General and Family Medicine , 27 (1), e70096. https://doi.org/10.1002/jgf2.70096 Additional Declarations No competing interests reported. Supplementary Files STROBEchecklistv4cohortDeathOccurence21April2026.doc Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 16 May, 2026 Reviewers agreed at journal 15 May, 2026 Reviewers agreed at journal 14 May, 2026 Reviewers agreed at journal 14 May, 2026 Reviewers invited by journal 14 May, 2026 Editor invited by journal 29 Apr, 2026 Editor assigned by journal 28 Apr, 2026 Submission checks completed at journal 28 Apr, 2026 First submitted to journal 22 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Al-Farsi","email":"","orcid":"","institution":"Sultan Qaboos University","correspondingAuthor":false,"prefix":"","firstName":"Yahya","middleName":"M.","lastName":"Al-Farsi","suffix":""}],"badges":[],"createdAt":"2026-04-22 05:09:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9490985/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9490985/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107620231,"identity":"6dff4cf3-72f6-46c5-8f20-61ca4d95ef7e","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":100924,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier Survival Curve of HIV/AIDS Patients in Oman by Gender (1992–2024)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/c8887cb145fd42484659a7b2.png"},{"id":107620233,"identity":"23290e06-d6db-491e-ae2f-a1580164bb73","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":138429,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier Survival Curve of HIV/AIDS Patients in Oman by Age Group (1992–2024)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/c38146c1cf8ac41521272282.png"},{"id":107620234,"identity":"fe679a23-4265-4d51-83bc-39aacc49d45e","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":55058,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCox Proportional Hazards Model-Estimated Survival Curves for Death Occurrence by Age at Diagnosis Among People Living with HIV in Oman (1992-2024).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/1d9b62e7819d44612aa12ad9.png"},{"id":107620237,"identity":"5ec2c10b-dfae-4dc2-9fcf-74337bbc9b93","added_by":"auto","created_at":"2026-04-23 09:35:28","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":69582,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCox Proportional Hazards Model-Estimated Survival Curves for Death Occurrence by WHO Clinical Stage at Diagnosis Among People Living with HIV in Oman (1992-2024).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/408a3aa5abbfc79153575be3.png"},{"id":107620235,"identity":"a1542d1d-4cb2-4d84-a808-a2b3c5a29baa","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":65921,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCox Proportional Hazards Model-Estimated Survival Curves for Death Occurrence by Year of HIV Diagnosis Among People Living with HIV in Oman (1992-2024).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/1aa838b4f1dbd255a973a435.png"},{"id":107620236,"identity":"72690f01-8663-4665-a70b-16f690c32f1d","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":45928,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCox Proportional Hazards Model–Estimated Survival Curves for Death Occurrence by Timing of cART Initiation Among People Living with HIV in Oman (1992–2024).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/e9f02972a6e5bb3a8960cdb5.png"},{"id":107620232,"identity":"7cfc0db2-3ba4-40ad-81ad-d1e6960856fa","added_by":"auto","created_at":"2026-04-23 09:35:27","extension":"doc","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":91136,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistv4cohortDeathOccurence21April2026.doc","url":"https://assets-eu.researchsquare.com/files/rs-9490985/v1/6b8a108eac194a29a9097ac7.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"Long-Term Survival and Predictors of Mortality among Adults Living with HIV Receiving Combination Antiretroviral Therapy in Oman: An Ambidirectional Cohort Study, 1992-2024","fulltext":[{"header":"1. Background","content":"\u003cp\u003eHuman immunodeficiency virus (HIV) infection continues to pose a major global public health challenge. Since the beginning of the epidemic in 1981, approximately 91.4\u0026nbsp;million people (range: 73.4 to 116.4\u0026nbsp;million) have been infected with the virus, and around 44.1\u0026nbsp;million (37.6 to 53.4\u0026nbsp;million) have died from AIDS-related illnesses (UNAIDS, 2024). HIV/AIDS remains a leading cause of morbidity and mortality, particularly in low- and middle-income countries (Kusumaadhi et al., 2021). In 2024 alone, approximately 1.3\u0026nbsp;million people (1.0 to 1.7\u0026nbsp;million) became newly infected with HIV, underscoring ongoing transmission risk (UNAIDS, 2024).\u003c/p\u003e \u003cp\u003eThe introduction of combined antiretroviral therapy (cART), has transformed HIV from a fatal diagnosis to a manageable chronic condition (Alwahibia et al., 2025). As a result, people living with HIV (PLWH) now often experience life expectancies that approach those of individuals without HIV (Alwahibia et al., 2025). Notably, about 31.6\u0026nbsp;million individuals (27.8\u0026ndash;32.9\u0026nbsp;million) were receiving ART in 2024 (UNAIDS, 2024).\u003c/p\u003e \u003cp\u003eSurvival among PLWH is typically defined as the time from initiation of cART to outcomes such as mortality, loss to follow-up, or retention in care. Survival outcomes vary significantly by region and are influenced by a range of individual-level factors (Kebede et al., 2020). The global burden of HIV-related mortality rose steadily between 1990 and 2005, peaking at 1.9\u0026nbsp;million deaths in 2005, before declining to 680,000 in 2021 and further to an estimated 630,000 deaths in both 2023 and 2024 (Awaidy et al., 2023; UNAIDS, 2023, 2024). During this period, the HIV-related mortality rate in the United States and its territories was 1.6 per 100 persons aged 13 and older with diagnosed HIV, with the highest rates observed in Southern states (CDC, 2025). In Ethiopia, the HIV-related mortality rate was reported at 4.2 per 100 person-years (equivalent to 3.5 deaths per 1,000 person-months), with major risk factors including older age, poor adherence to cART, tuberculosis (TB) co-infection, non-disclosure of HIV status, being bedridden at presentation, and severe anaemia (Kebede et al., 2020). Similarly, a study in Indonesia identified male sex, age\u0026thinsp;\u0026ge;\u0026thinsp;45 years, advanced WHO clinical stage (III/IV), low CD4 count (\u0026le;\u0026thinsp;200 cells/mm\u0026sup3;), poor treatment adherence, TB co-infection, and anaemia as significant predictors of mortality (Kusumaadhi et al., 2021).\u003c/p\u003e \u003cp\u003eContrary to the global trend, the burden of HIV/AIDS-related mortality has increased in parts of the Eastern Mediterranean Region (EMR) (GBD 2015 Eastern Mediterranean Region HIV/AIDS Collaborators, 2018). In the Middle East and North Africa (MENA), mortality peaked at 11,000 deaths in 2013, before falling to 7,900 by 2020 (Elgalib et al., 2020). In 2021, Saudi Arabia recorded over 200 HIV-related deaths, while Qatar and United Arab Emirates (UAE) each reported fewer than 100, while reliable mortality data for Kuwait remain limited (Awaidy et al., 2023; UNAIDS, 2023). These regional variations highlight the persistent inequities in access to prevention, diagnosis, and care across global contexts, despite overall improvements in HIV control.\u003c/p\u003e \u003cp\u003eIn Oman, approximately 2,800 people were living with HIV in 2023 (Alwahibia et al., 2025). A local retrospective study reported an average survival time of 8.5 years (102 months) among PLWH, with 44% (689 of 1,566) surviving beyond eight years (Elgalib et al., 2020). The study also highlighted a sex disparity in mortality: by December 2018, 40.3% of diagnosed females had died, compared to 52.1% (1,152 of 2,212) of males. Despite these insights, the factors influencing long-term survival among HIV-positive individuals receiving cART in Oman remain poorly understood. Existing research has largely focused on prevalence and treatment outcomes, relying primarily on cross-sectional designs that limit causal inference (Elgalib et al., 2020; Karbasi et al., 2023).\u003c/p\u003e \u003cp\u003eGiven these gaps, this study aimed to explore survival outcomes and identify predictors of mortality among adults living with HIV at the national tertiary referral center, Royal Hospital. This study offers valuable insights for national HIV care programs by enhancing the understanding of long-term survival patterns and informing targeted interventions aimed at reducing mortality. The findings may support evidence-based decision-making to optimize care delivery and resource allocation in Oman.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Aim\u003c/h2\u003e \u003cp\u003eThe primary aim of this study was to examine long-term survival and identify predictors of mortality among adults living with HIV receiving cART in Oman over 32 years (1992\u0026ndash;2024).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Design\u003c/h2\u003e \u003cp\u003eThis ambidirectional cohort study utilized data from the national HIV/AIDS registry at the Royal Hospital, Oman. The study incorporated retrospective data from 1 January 1992 to 26 August 2024 and prospective data collected between 27 August and 31 December 2024, resulting in an overall observation period of January 1992 to December 2024.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Setting\u003c/h2\u003e \u003cp\u003e The study was conducted at the Royal Hospital in Muscat, Oman, the national tertiary referral center for HIV care. The hospital provides specialized management of complex HIV cases under infectious disease specialists and maintains a national registry for clinical follow-up and treatment monitoring. The facility has a large inpatient capacity and serves as a referral center for HIV care across the country (Royal Hospital- MOH, 2026).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Participants (Inclusion and Exclusion Criteria)\u003c/h2\u003e \u003cp\u003eThe study population consisted of adults aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years diagnosed with HIV infection and receiving care at the Royal Hospital who initiated cART during the study period. HIV infection was confirmed using the national diagnostic algorithm, including Western blot and other confirmatory assays.Participants were included if they had complete baseline laboratory data for CD4 cell count, viral load, and hemoglobin levels. Individuals with incomplete baseline clinical or laboratory data required for survival analysis were excluded to ensure data integrity and minimize information bias.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data Sources and Data Collection\u003c/h2\u003e \u003cp\u003eData were extracted from the Al-Shifa 3\u0026thinsp;+\u0026thinsp;electronic health record system using a structured Excel-based checklist. Retrospective data for patients diagnosed between 1992 and 26 August 2024 were retrieved from the electronic registry. From 27 August 2024 onward, prospective follow-up data were collected to update clinical outcomes and treatment information. The study relied entirely on routinely recorded hospital registry data, with no direct participant contact or interviews conducted.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Study Variables\u003c/h2\u003e \u003cp\u003eThe study collected sociodemographic, clinical, and laboratory variables. Socio-demographic variables included age at diagnosis, sex, marital status, and employment status. Clinical variables included mode of HIV transmission, comorbidities, WHO clinical stage at diagnosis, cART initiation date, cotrimoxazole prophylaxis use, treatment adherence, and reported cART-related adverse effects. WHO clinical stage at diagnosis was classified according to the World Health Organization HIV clinical staging guidelines as Stage 1 (asymptomatic), Stage 2 (mild symptoms), Stage 3 (advanced symptoms), and Stage 4 (severe symptoms/AIDS) (Twabi et al., 2026). Laboratory variables included baseline CD4 cell count, viral load, and hemoglobin level, with 10 g/dL used as the cut-off value.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e\u003cb\u003e2\u003c/b\u003e.\u003cb\u003e5.1 Outcome Definition\u003c/b\u003e\u003c/h2\u003e \u003cp\u003eThe primary outcome was all-cause mortality among adults living with HIV receiving cART at the Royal Hospital, classified as a binary outcome (mortality vs. censored non-mortality). Death events were identified through hospital medical records and routine follow-up documented in the Al-Shifa 3\u0026thinsp;+\u0026thinsp;electronic system (Shifa3+). Time-to-event was defined as the interval between HIV diagnosis and the date of death. Participants who were alive at the end of follow-up or lost to follow-up were classified as censored non-mortality observations, with follow-up ending on 31 December 2024 (Gomes et al., 2026). Survival analyses, including Cox proportional hazards regression, were conducted to assess factors associated with mortality while accounting for censored non-mortality outcomes (Gomes et al., 2026).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Bias Considerations\u003c/h2\u003e \u003cp\u003eObservational cohort studies are susceptible to several sources of bias, including selection bias, information bias, misclassification bias, and immortal time bias (Aschengrau \u0026amp; Seage, 2020). Selection bias was addressed by eligible patients from the national HIV registry and applying consistent inclusion criteria since the selection bias occurs when the study sample differs systematically from the target population (Aschengrau \u0026amp; Seage, 2020). In this study, selection bias was minimized by including all eligible adults recorded in the national HIV registry in Oman between 1992 and 2024 with complete baseline clinical and laboratory data and by applying consistent inclusion and exclusion criteria.\u003c/p\u003e \u003cp\u003eInformation bias arises from systematic errors in the measurement of exposures, covariates, or outcomes (Aschengrau \u0026amp; Seage, 2020).This risk was reduced through the use of standardized electronic medical records from the Al Shifa 3\u0026thinsp;+\u0026thinsp;system, which minimized reliance on patient recall. Misclassification bias, a subtype of information bias, occurs when participants are incorrectly categorized with respect to exposures or outcomes (Aschengrau \u0026amp; Seage, 2020). This was limited by applying the WHO HIV clinical staging guidelines for disease classification and predefined laboratory thresholds (Twabi et al., 2026).\u003c/p\u003e \u003cp\u003eImmortal time bias can occur in time-to-event analyses when periods of guaranteed survival are misclassified, potentially overestimating survival (Huang et al., 2025). In this study (January 1992-31 December 2024), follow-up was defined from HIV diagnosis until death or study end, and Kaplan-Meier and Cox regression accounted for censoring and loss to follow-up, reducing attrition bias (Bekele et al., 2024; Dudley et al., 2016).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Sample Size Calculation\u003c/h2\u003e \u003cp\u003eThe required sample size was calculated using OpenEpi version 3.01, assuming a 95% confidence level, 5% significance level, and 80% power (Hajian-Tilaki, 2014). Estimation was based on a previous study involving 1,245 patients with documented CD4 counts from 1984 to 2018, in which 59.3% of the non-exposed group had CD4 counts\u0026thinsp;\u0026gt;\u0026thinsp;200 cells/mm\u0026sup3; and 40.7% of the exposed group had CD4 counts\u0026thinsp;\u0026lt;\u0026thinsp;200 cells/mm\u0026sup3; (Elgalib et al., 2020).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.8 Sampling Method\u003c/h2\u003e \u003cp\u003eA total of 549 patients were included from the Royal Hospital HIV registry using a convenience sampling technique. As the Royal Hospital serves as the national referral center for HIV care in Oman, the registry includes patients from across the country, enhancing representativeness. Although convenience sampling can theoretically limit generalizability, the national scope of the hospital supports reasonable external validity of the findings (Andrade, 2021; Wang et al., 2016; Zrineh et al., 2026).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e2.9 Data Analysis\u003c/h2\u003e \u003cp\u003eStatistical analyses were performed using IBM SPSS Statistics (Version 27). Categorical variables were summarized as frequencies and percentages, and group differences were assessed using chi-square tests (Kaliyadan \u0026amp; Kulkarni, 2019).\u003c/p\u003e \u003cp\u003eKaplan-Meier survival analysis was used to estimate survival probabilities and time to mortality among people living with HIV (PLWH) (Dudley et al., 2016). Mortality incidence rates were calculated per 1,000 person-months of follow-up. Survival time was measured in months from the date of HIV diagnosis to the date of mortality (Aschengrau \u0026amp; Seage, 2020). Participants alive at the end of follow-up or lost to follow-up were treated as right-censored observations at their last clinical visit (Beis et al., 2024; Gebre et al., 2025; Prinja et al., 2010).\u003c/p\u003e \u003cp\u003eCox proportional hazards regression was applied to identify predictors of mortality while adjusting for potential confounders (Gomes et al., 2026). All variables were entered simultaneously using the enter method in the Cox model. Results were reported as crude hazard ratios (HRs) and adjusted hazard ratios (AHRs) with 95% confidence intervals, with P\u0026thinsp;\u0026le;\u0026thinsp;0.05 considered statistically significant. The proportional hazards assumption for the Cox regression model was evaluated using log-minus-log survival plots and statistical diagnostics, and no violation of the proportional hazards assumption was observed.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Socio-demographic characteristics of people living with HIV (PLWH)\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the socio-demographic profile of 549 individuals diagnosed with HIV in Oman, classified by patient status: death (n\u0026thinsp;=\u0026thinsp;99) and censored (alive or lost to follow-up; n\u0026thinsp;=\u0026thinsp;450). Deaths were notably higher among males, who comprised 80.8% (n\u0026thinsp;=\u0026thinsp;80) of the deaths (p\u0026thinsp;=\u0026thinsp;0.005). Age also exhibits a significant difference (p\u0026thinsp;=\u0026thinsp;0.002); patients aged 28 to 37 accounted for a larger proportion of deaths (27.3%, n\u0026thinsp;=\u0026thinsp;27) compared to the other three age groups. The year of diagnosis shows a significant association (p\u0026thinsp;=\u0026thinsp;0.001), with those diagnosed in 2008 or earlier experienced the highest proportion of deaths (45.5%, n\u0026thinsp;=\u0026thinsp;45) relative to those diagnosed in subsequent years. Marital status is also significantly related to survival (p\u0026thinsp;=\u0026thinsp;0.003), as deaths were more common among married individuals (48.5%, n\u0026thinsp;=\u0026thinsp;48). Additionally, deaths were higher among those who were unemployed (55.6%, n\u0026thinsp;=\u0026thinsp;55) (p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of HIV/AIDS patients, stratified by patients\u0026rsquo; status (mortality and censored), in Oman from 1992 to 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;549)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;450)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e379 (69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80 (80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299 (66.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e170 (31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e151 (33.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNationality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.339\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmani\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e530 (96.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94 (94.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e436 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Omani\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18 to 27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142 (26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (21.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e125 (27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28 to 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e206 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e179 (39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38 to 47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116 (21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (26.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e90 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e48 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81 (14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (25.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYears of diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2008 or earlier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97 (21.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2009 to 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e147 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (31.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e116 (25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015 to 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e127 (28.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2024 or later\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118 (21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e110 (24.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot disclosed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e194 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (39.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e155 (34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e287 (52.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e239 (53.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot disclosed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e224 (49.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254 (46.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e199 (44.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e* Significant p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Clinical characteristics of people living with HIV\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents a summary of the clinical characteristics of 549 individuals living with HIV, comparing those who died (n\u0026thinsp;=\u0026thinsp;99) to those who were censored (n\u0026thinsp;=\u0026thinsp;450). The mode of transmission was found to be significantly associated with mortality (p\u0026thinsp;=\u0026thinsp;0.001). Nearly half of the deceased patients had an unknown transmission route (48.5%, n\u0026thinsp;=\u0026thinsp;48), followed by sexual transmission (40.4%, n\u0026thinsp;=\u0026thinsp;40). The reason for HIV testing also demonstrated a strong association with outcomes (p\u0026thinsp;=\u0026thinsp;0.001), as most patients who died had been diagnosed after presenting HIV-related symptoms (85.9%, n\u0026thinsp;=\u0026thinsp;85). WHO clinical staging emerged as a significant predictor of survival (p\u0026thinsp;=\u0026thinsp;0.001), with severe symptoms (stage 4 or AIDS) reported in 60.6% (n\u0026thinsp;=\u0026thinsp;60) of those who died. Deaths also differed significantly by comorbidity status (p\u0026thinsp;=\u0026thinsp;0.001), with a higher prevalence of patients without comorbidities among those who died (34.3%, n\u0026thinsp;=\u0026thinsp;34). Notably, the incidence of cancer (23.2%, n\u0026thinsp;=\u0026thinsp;23) and renal disease (10.1%, n\u0026thinsp;=\u0026thinsp;10) was disproportionately higher among deceased patients compared to their censored counterparts. Timely initiation of cART was observed in 77.8% (n\u0026thinsp;=\u0026thinsp;77) of mortality cases, contrasting with 22.2% (n\u0026thinsp;=\u0026thinsp;22) who delayed treatment. Additionally, deaths were more frequent among those with a hemoglobin level above 10 g/dL (55.5%, n\u0026thinsp;=\u0026thinsp;55) compared to those with 10 g/dL or lower (44.4%, n\u0026thinsp;=\u0026thinsp;44) (p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical characteristics of HIV/AIDS patients, stratified by patients\u0026rsquo; status (mortality and censored), in Oman from 1992 to 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;549)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;450)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMode of Transmission\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot disclosed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e83 (18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e359 (65.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (40.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e319 (70.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParenteral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReason for HIV Testing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot disclosed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntenatal Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42 (7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital checkup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV Contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e103 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99 (22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTest Request\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e304 (55.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 (85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e219 (48.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOfficial Document/Prisoner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWHO\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e \u003cb\u003eclinical Staging\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 1: Asymptomatic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e213 (38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e205 (45.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 2: Mild symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 3: Advanced symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146 (26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e118 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 4: Severe symptoms (AIDS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165 (30.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60 (60.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e105 (23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e288 (52.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (34.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e254 (56.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51 (9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThyroid disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenal disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychiatric disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyslipidemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime cART\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e \u003cb\u003einitiation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTimely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e496 (90.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e419 (93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeferred (Active TB\u003csup\u003ec\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHaemoglobin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10 g/dL or less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128 (23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84 (18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 10 g/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e421 (76.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e366 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eWHO: World Health Organization\u003c/em\u003e, \u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e\u003cem\u003ecART: Combined Antiretroviral Therapy.\u003c/em\u003e \u003csup\u003e\u003cem\u003ec\u003c/em\u003e\u003c/sup\u003e \u003cem\u003eTuberculosis. * Significant p-value\u0026le;.05.\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Co-infection Among people living with HIV\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e demonstrates that coinfections were significantly linked to mortality rates among HIV/AIDS patients. Specifically, deaths were more frequently observed among patients without TB infection (57.6%, n\u0026thinsp;=\u0026thinsp;57.6) compared to those with active TB (23.2%, n\u0026thinsp;=\u0026thinsp;23). Regarding syphilis infection, deaths were more frequently observed among individuals without documented infection (74.7%, n\u0026thinsp;=\u0026thinsp;74) (p\u0026thinsp;=\u0026thinsp;0.001). Similarly, for HCV infection, mortality was more prevalent among those without the infection (73.7%, n\u0026thinsp;=\u0026thinsp;73) compared to those with positive HCV status (17.2%, n\u0026thinsp;=\u0026thinsp;17).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCo-infection in people living with HIV, stratified by patients\u0026rsquo; status (mortality and censored), in Oman from 1992 to 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;549)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;450)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTuberculosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown/Not done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91 (16.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58 (10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e400 (72.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (57.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e343 (76.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHBsAg\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown/Not done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e499 (90.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86 (86.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e413 (91.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSyphilis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown/Not done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33 (7.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e463 (84.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74 (74.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e389 (86.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHCV IgG\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.007*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown/Not done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64 (11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47 (10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e460 (83.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73 (73.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e387 (86.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eHBsAg\u003c/em\u003e: \u003cem\u003eHepatitis B surface antigen\u003c/em\u003e, \u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e \u003cem\u003eHCV IgG: Hepatitis C IgG antibody, * Significant p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Behavioral risk factors among people living with HIV\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e suggests that there was no significant association between behavioral risk factors and mortality. Deaths occurred more frequently among individuals who did not engage in risky behaviors compared to those who were smokers, alcohol users, injection drug users, or individuals who had been imprisoned, with frequencies of n\u0026thinsp;=\u0026thinsp;23 (23.2%), n\u0026thinsp;=\u0026thinsp;18 (18.2%), n\u0026thinsp;=\u0026thinsp;7 (7.1%), and n\u0026thinsp;=\u0026thinsp;4 (4.0%), respectively.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBehavioral risk factors of HIV/AIDS patients, stratified by patients\u0026rsquo; status (mortality and censored), in Oman from 1992 to 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;549)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;450)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.380\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e363 (80.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e439 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76 (76.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87 (19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol Consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.675\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e92 (16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74 (16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e457 (83.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e376 (83.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjection drug users (IDU)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.754\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e514 (93.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92 (92.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e422 (93.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImprisonment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.368\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e532 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95 (96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e437 (97.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e* Significant p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Reasons for mortality among people living with HIV\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e summarizes data on deaths among 99 HIV cases at the Royal Hospital in Oman, which includes 83 AIDS-related deaths and 16 non-AIDS-related deaths. Among the total cases, 80 (80.8%) were male, with 67 (80.7%) in the AIDS group and 13 (81.3%) in the non-AIDS group. The remaining 19 individuals (19.2%) were female, consisting of 16 (19.3%) in the AIDS group and 3 (18.8%) in the non-AIDS group, indicating a statistically significant difference (P\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e \u003cp\u003eIn terms of WHO clinical staging, 60 patients (60.6%) were classified as being in the severe stage (stage 4), with 55 (66.3%) of these deaths being AIDS-related, compared to 5 (31.3%) non-AIDS deaths. Additionally, 28 patients (28.2%) exhibited advanced symptoms (stage 3), including 21 (25.3%) AIDS-related and 7 (43.8%) non-AIDS deaths. There were 8 patients (8.0%) in the asymptomatic category (stage 1), with 5 (6.0%) being AIDS-related and 3 (18.8%) non-AIDS, while 3 (3.0%) had mild symptoms (stage 2), including 2 (2.4%) AIDS-related and 1 (6.3%) non-AIDS. The association between WHO stage and cause of mortality was found to be statistically significant (P\u0026thinsp;=\u0026thinsp;0.001), with AIDS-related deaths occurring more frequently among patients in the advanced (stage 3) or severe (stage 4) stages.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReasons of Mortality among people living with HIV in Oman, (1992\u0026ndash;2024).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAIDS Related Mortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon-AIDS Related Mortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;99\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;83\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;16\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003cem\u003e*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80 (80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67 (80.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWHO Clinical Staging\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003cem\u003e*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 1: Asymptomatic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 2: Mild symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 3: Advanced symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (28.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (25.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 4: Severe symptoms (AIDS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60 (60.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (66.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (31.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e* Significant p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Mortality Incidence Rate among people living with HIV\u003c/h2\u003e \u003cp\u003eThe overall incidence rate of mortality among People living with HIV (PLWH) in the study was approximately 2 deaths per 1,000 person-months (95% CI: [1.21, 1.80]) during the follow-up period. When analyzed by gender, males exhibited a higher mortality rate of 2 deaths per 1,000 person-months (95% CI: [1.44, 2.25]), in comparison to females, who had an incidence rate of 1 death per 1,000 person-months (95% CI: [0.46, 1.22]). This suggests that male patients faced a greater risk of mortality.\u003c/p\u003e \u003cp\u003eAge also revealed a significant pattern: younger patients aged 18\u0026ndash;27 had a lower death incidence rate of 1 death per 1,000 person-months (95% CI: [0.6, 1.4]), while those in the age groups of 28\u0026ndash;37 and 38\u0026ndash;47 had moderately higher rates, averaging around 2 deaths per 1,000 person-months. Notably, patients aged 48 years and older experienced the highest death rate, with 4 deaths per 1,000 person-months (95% CI: [2.2, 5.1]).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMortality Incidence Rates by Gender and Age Group (Years) among People Living with HIV in Oman, 1992\u0026ndash;2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCases (Mortality)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePerson-months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIncidence Rate /1000\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% CI\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e(Lower, Upper)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65,803\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1.21,1.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43,396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1.44,2.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22,407\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0.46,1.22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge group (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18 to 27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20,776\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0.60,1.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28 to 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25,105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1.00,2.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38 to 47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13,112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1.20,2.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e48 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,810\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(2.20,5.10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eCI: Confidence Intervals, The Mortality incidence rate was calculated by dividing the number of new Mortality cases by the total person-time (in months) and multiplying the result by 1,000\u003c/em\u003e (Aschengrau \u0026amp; Seage, 2020).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e3.7 Kaplan-Meier Survival Analysis of people living with HIV in Oman (1992\u0026ndash;2024) by Gender and Age\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e presents the mean survival times and 95% confidence intervals (CIs) among people living with HIV/AIDS in Oman from 1992 to 2024. The overall mean survival time was 298.7 months (SE\u0026thinsp;=\u0026thinsp;8.9, 95% CI [281.1, 316.3]). Median survival time was not reached because the cumulative survival probability never fell below 0.50 during the follow-up period.\u003c/p\u003e \u003cp\u003eWhen analyzed by gender, females had a longer mean survival time (326.0 months, SE\u0026thinsp;=\u0026thinsp;16.2, 95% CI [294.2, 357.8]) compared with males (280.2 months, SE\u0026thinsp;=\u0026thinsp;10.0, 95% CI [260.6, 299.9]). The log-rank test reported a statistically significant difference between genders (χ\u0026sup2; = 7.63, df\u0026thinsp;=\u0026thinsp;1, p\u0026thinsp;=\u0026thinsp;0.006), suggesting higher survival probabilities for females throughout the follow-up period. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates these differences.\u003c/p\u003e \u003cp\u003eSurvival also varied by age group. Patients aged 28\u0026ndash;37 years had the highest mean survival time (324.4 months, SE\u0026thinsp;=\u0026thinsp;13.3, 95% CI [298.3, 350.5]), whereas those aged 38\u0026ndash;47 years had the lowest (233.9 months, SE\u0026thinsp;=\u0026thinsp;13.0, 95% CI [208.5, 259.5]). The log-rank test showed significant differences across age groups (χ\u0026sup2; = 27.98, df\u0026thinsp;=\u0026thinsp;3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the Kaplan\u0026ndash;Meier curves by age, highlighting differences in survival probabilities over time. Median survival times are not reported for most strata because the cumulative survival probability did not fall below 0.50 during the study period, making median estimation not feasible.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKaplan\u0026ndash;Meier Survival Estimates and Tests of Equality of Survival Distributions by Gender and Age among People Living with HIV/AIDS in Oman (1992\u0026ndash;2024)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean Survival Time, months (SEᵃ)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CIᵇ (Lower, Upper)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian Survival Timeᶜ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLog-Rank χ\u0026sup2; (df), p-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBreslow χ\u0026sup2; (df), p-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTarone\u0026ndash;Ware χ\u0026sup2; (df), p-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e298.7 (8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(281.1, 316.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.629 (1), 0.006*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.749 (1), 0.005*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.182 (1), 0.004*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.006*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e280.2 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(260.6,299.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e326.0 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(294.2,357.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.981 (3), 0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30.800 (3), 0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e30.624(3), 0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e310.9 (13.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(284.7, 337.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28\u0026ndash;37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e324.4 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(298.3,350.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38\u0026ndash;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e233.9 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(208.5,259.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e298.7 (8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(281.1,316.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot reached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eSE: standard error;\u003c/em\u003e \u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eCI: confidence interval. Median survival could not be estimated for some strata due to limited events.Median survival could not be estimated for some strata due to limited events.\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cb\u003ec\u003c/b\u003e \u003c/sup\u003e \u003cem\u003eMedian survival time was not reached because more than 50% of patients remained alive at the end of follow-up.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e3.8 Factors Associated with the Occurrence of Mortality (Cox Regression)\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e shows the results of the adjusted Cox proportional hazards regression analysis of factors associated with mortality among people living with HIV. Age at diagnosis was significantly associated with mortality. Compared with individuals aged\u0026thinsp;\u0026ge;\u0026thinsp;48 years, those aged 18\u0026ndash;27 years (AHR\u0026thinsp;=\u0026thinsp;0.37, 95% CI: 0.16\u0026ndash;0.84) and 28\u0026ndash;37 years (AHR\u0026thinsp;=\u0026thinsp;0.31, 95% CI: 0.15\u0026ndash;0.63) had a lower hazard of mortality. The WHO clinical stage at diagnosis was also significantly associated with mortality. Participants diagnosed at stage 1 (asymptomatic) (AHR\u0026thinsp;=\u0026thinsp;0.23, 95% CI: 0.09\u0026ndash;0.58), stage 2 (mild symptoms) (AHR\u0026thinsp;=\u0026thinsp;0.23, 95% CI: 0.09\u0026ndash;0.58), and stage 3 (advanced symptoms) (AHR\u0026thinsp;=\u0026thinsp;0.39, 95% CI: 0.23\u0026ndash;0.64) had lower mortality risk compared with those diagnosed at stage 4 (severe symptoms).In addition, low hemoglobin levels (\u0026lt;\u0026thinsp;10 g/dL) were associated with increased mortality (AHR\u0026thinsp;=\u0026thinsp;1.75, 95% CI: 1.09\u0026ndash;2.81).. Female patients showed higher survival probabilities and lower cumulative hazard of mortality throughout the follow-up period compared with male patients.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable Cox Proportional Hazards modelling of Factors Associated with the occurrence of mortality among People living with HIV (PLWH), Oman, 1992\u0026ndash;2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eCrude Model\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003eAdjusted Model\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHR\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eL95CI\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eU95CI\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAHR\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eL95CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eU95CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears of diagnosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2008 or before\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.661\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2009 to 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.418\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015 to 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.711\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2020 or later\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge at Diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18 to 27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.018*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28 to 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38 to 47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e48 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWHO\u003c/b\u003e\u003csup\u003e\u003cb\u003ee\u003c/b\u003e\u003c/sup\u003e \u003cb\u003eclinical staging\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 1: Asymptomatic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 2: Mild symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.029*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 3: Advanced symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage 4: Severe symptoms (AIDS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReason for Testing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntenatal care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital checkup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.705\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.280\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV Contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.570\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTest Request\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.974\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOfficial Document/Prisoner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime cART\u003c/b\u003e\u003csup\u003e\u003cb\u003ef\u003c/b\u003e\u003c/sup\u003e \u003cb\u003einitiation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTimely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeferred (Active TB\u003csup\u003eg\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMode of Transmission\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenderual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.976\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParenteral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e11.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.365\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 Comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 Comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.880\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 or more comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTuberculosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.631\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHCV IgG\u003c/b\u003e\u003csup\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.850\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSyphilis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.299\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHemoglobin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10 g/dL or less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.019*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 10 g/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eHazard Ratio;\u003c/em\u003e \u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eLower 95% Confidence Interval;\u003c/em\u003e \u003csup\u003e\u003cem\u003ec\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eUpper 95% Confidence Interval;\u003c/em\u003e \u003csup\u003e\u003cem\u003ed\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eAdjusted Hazard Ratio;\u003c/em\u003e \u003csup\u003e\u003cem\u003ee\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eWHO: World Health Organization;\u003c/em\u003e \u003csup\u003e\u003cem\u003ef\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eCART: Combined anti-retroviral treatment;\u003c/em\u003e \u003csup\u003e\u003cem\u003eg\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eTB: Tuberculosis.\u003c/em\u003e \u003csup\u003e\u003cem\u003eh\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eHBsAg\u003c/em\u003e: \u003cem\u003eHepatitis B surface antigen\u003c/em\u003e, \u003csup\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sup\u003e\u003cem\u003eHCV IgG: Hepatitis C IgG antibody. * Significant p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates that people living with HIV (PLWH) diagnosed at age 48 and above exhibit lower survival probabilities and a higher risk of mortality over time compared to younger age groups. Conversely, patients diagnosed between 18 and 37 years demonstrate notably better survival outcomes throughout the follow-up period.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows that survival decreases with advancing WHO clinical stage. Patients with severe or advanced symptoms had lower survival, while asymptomatic and mildly symptomatic patients showed better outcomes, emphasizing the importance of early diagnosis and treatment.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe Cox regression Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e indicates improved survival among HIV/AIDS patients over time. Patients diagnosed after 2020 demonstrated the highest survival and lowest cumulative hazard, while those diagnosed before 2008 had the poorest outcomes. These findings suggest significant advancements in HIV management and treatment across the study period.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe survival and hazard Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e indicate that patients who initiated cART within the first two weeks of active TB infection had lower survival rates and a higher cumulative hazard compared to those who started treatment promptly.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study aimed to assess predictors of mortality among adult People living with HIV (PLWH) on cART at the Royal Hospital, Oman, from 1992 to 2024. Over the 32 years, a total of 99 deaths were recorded among adults receiving cART, of whom 19 were female and the remaining 80 were male.\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Incidence rate of Mortality among PLWH\u003c/h2\u003e \u003cp\u003eThe overall mortality incidence rate in our study was 1.5 deaths per 1,000 person-months (95%CI: [1.2, 1.8]) of follow-up of 65,803 person-months. In contrast, a study from British Columbia, Canada, reported 3,401 deaths over 562,150 person-years (equivalent to 6,745.8 units of 1,000 person-months), yielding a much lower incidence rate of approximately 6 deaths per 1,000 person-years ( equivalent to 0.5 deaths per 1,000 person-months) (Eyawo et al., 2017). Additionally, in Ethiopia, a study showed that the overall incidence rate of mortality is 4.6 per 1,000 person-years (which is equivalent to approximately 0.38 deaths per 1,000 person-months). (Teshale \u0026amp; Awoke, 2022). This suggests that the mortality rate observed in our study is substantially higher than that reported in the Ethiopian context and Canada. This difference may be due to variations in patient characteristics, healthcare systems, and timing of cART initiation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec25\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Incidence Rate of Mortality Among PLWH Based on Gender\u003c/h2\u003e \u003cp\u003eThe mortality incidence rate among males was 1.8 deaths per 1,000 person-months, which showed higher mortality among males than females (0.8 deaths per 1,000 person-months). This disparity may be partly explained by greater opportunities females have for early HIV diagnosis, particularly during pregnancy through routine antenatal screening (Jeong et al., 2016; Rao et al., 2018). Additionally, higher mortality among males may be attributed to behavioral factors such as substance use, which can contribute to delayed diagnosis and poor adherence to cART. This finding aligns with a study conducted in Indonesia showed that mortality is higher among males than females (Kusumaadhi et al., 2021). Similarly, another study done in Northwest Ethipoia also showed that mortality is AHR\u0026thinsp;=\u0026thinsp;2.4 times higher among males than females (Workie et al., 2021). However, in contrast, another study in Ethiopia showed that mortality is higher among females, N\u0026thinsp;=\u0026thinsp;172 (63.0%), than males, N\u0026thinsp;=\u0026thinsp;101 (37.0%) (Teshale \u0026amp; Awoke, 2022).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Incidence Rate of Mortality Among PLWH Based on Age at Diagnosis\u003c/h2\u003e \u003cp\u003eConsistent with the findings presented earlier, age at diagnosis showed that the mortality incidence rate was higher among those who aged 48 years and above (3.7/1000 person-month, 95% CI: [2.2, 5.1]) than in younger age groups. This is consistent with previous studies showing that mortality risk is higher in older age groups (Kebede et al., 2020; Kusumaadhi et al., 2021; Teshale \u0026amp; Awoke, 2022). In the U.S, for instance, 30% of deaths occurred among those aged 55 to 64 years in 2023 (CDC, 2025). This may be due to stronger immune systems and better response to treatment in younger individuals, as well as fewer comorbid conditions compared to older patients. In addition, it is well established that as age increases, immune status becomes incompetent, which is considered to be a risk for many chronic diseases (Lee et al., 2022; Vassallo et al., 2025) (Lee et al., 2022) and age-related thymic involution and declining immune function, which accelerate HIV progression and increase mortality risk (Goyani et al., 2024; Thomas et al., 2020). The European Study in Infections among Adults (EuroSIDA) study, which followed PLWH from 2001 to 2020, reported that the overall mortality declined over time due to improved cART coverage and care standards; age remained a strong independent risk factor (Kraef et al., 2024).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Association of Age at Diagnosis with Mortality Among HIV/AIDS Patients\u003c/h2\u003e \u003cp\u003eConsistent with the findings above, age at diagnosis also significantly influenced survival. Patients diagnosed at a younger age, especially those aged 18\u0026ndash;27 and 28\u0026ndash;37 years, had a lower risk of mortality compared to those aged 48 and above. Similar to previous studies, mortality risk was higher in older age groups (Bajpai et al., 2014; Kebede et al., 2020; Teshale \u0026amp; Awoke, 2022; Uma et al., 2012). This may be due to stronger immune systems and better response to treatment in younger individuals, as well as fewer comorbid conditions compared to older patients (Lee et al., 2022). In addition, it is known that as age increases, immune status becomes incompetent, which is considered to be a risk for many chronic diseases, leading to mortality (Lee et al., 2022; Vassallo et al., 2025). The European Study in Infections among Adults (EuroSIDA) study, which followed PLWH from 2001 to 2020, reported that the overall mortality declined over time due to improved cART coverage and care standards; age remained a strong independent risk factor (Kraef et al., 2024).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Association of WHO Clinical Staging with Mortality Among HIV/AIDS Patients\u003c/h2\u003e \u003cp\u003eWHO clinical stage at diagnosis was another strong predictor of mortality. Patients who were asymptomatic (stage 1) or had mild (stage 2) to advanced symptoms (stage 3) at the time of diagnosis had significantly better survival outcomes than those diagnosed at a severe stage. These results emphasize the value of early diagnosis and regular screening programs to identify HIV infections before they progress. Consistent with a previous study conducted in Ethiopia, which showed that individuals with WHO clinical stages 1, 2, and 3 had a better survival time than those with stage 4 (Nigussie et al., 2020). A systematic review and meta-analysis in sub-Saharan Africa also showed that the WHO clinical staging (3\u0026ndash;4) is related to a high mortality rate (Haumba et al., 2024). Starting cART immediately after HIV diagnosis can significantly reduce HIV-related morbidity and mortality. Additionally, those with advanced stage need close monitoring during the early treatment phase to assess cART response and detect potential immune reconstitution inflammatory syndrome (Nigussie et al., 2020).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Association of Low Hemoglobin Level with Mortality Among HIV/AIDS Patients\u003c/h2\u003e \u003cp\u003eOur study highlighted that hemoglobin levels less than 10 g/dl were 1.97 times were associated with a higher risk of mortality. This association may be attributed to anemia, a common complication among PLWH that often indicates an advanced stage of the disease (WHO, 2015). Consistent with our findings, a study conducted in Ethiopia revealed that severe anemia increases the risk of mortality among PLWH by 4.57 times compared to those with normal hemoglobin levels (Damtew et al., 2015). Furthermore, research in Indonesia demonstrated that the likelihood of mortality is 2.308 times higher for individuals with hemoglobin levels below 10 g/dL (Kusumaadhi et al., 2021). This study provides one of the longest follow-up cohorts of people living with HIV in the region.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec30\" class=\"Section2\"\u003e \u003ch2\u003e4.7 Limitation\u003c/h2\u003e \u003cp\u003eThis study has some limitations. Key variables such as stigma, mental health, education, income, and treatment literacy were not available, limiting analysis of social determinants. Missing follow-up and clinical data for a small number of patients may have introduced minor bias. Changes in diagnostics and treatment protocols over the 32-year study period may have affected data consistency. Mortality may have been underestimated, particularly among those lost to follow-up, and unmeasured confounding cannot be excluded due to the observational nature of the study.\u003c/p\u003e \u003cp\u003ePotential sources of bias were considered during the study design and analysis, as described in the Methods. Selection bias may have arisen from the inclusion of patients with complete baseline data, although efforts were made to include all eligible individuals from the national registry. Information bias and misclassification may be present due to reliance on routinely recorded clinical data; however, the use of standardized electronic medical records and WHO clinical staging criteria likely minimized these effects. In addition, although time-to-event methods were used, residual bias related to the timing of treatment initiation cannot be entirely excluded. These limitations should be considered when interpreting the findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe overall mortality incidence rate among individuals living with HIV/AIDS in Oman receiving combination antiretroviral therapy was 1.5 deaths per 1,000 person-months. Younger age, earlier clinical stage at diagnosis, and hemoglobin levels were significantly associated with survival. These findings highlight the importance of early diagnosis, prompt initiation of treatment, and continuous clinical monitoring to reduce HIV-related mortality.\u003c/p\u003e \u003cp\u003eImproving HIV outcomes in Oman requires strengthening early HIV testing strategies, particularly among older adults and high-risk groups, to minimize late-stage diagnoses. Addressing gender disparities in HIV care is also essential, with targeted interventions needed to improve engagement, treatment adherence, and follow-up among male patients. In addition, integrating anemia management into routine HIV care and ensuring timely initiation and sustained adherence to cART may further enhance patient survival and clinical outcomes.\u003c/p\u003e \u003cp\u003eAlthough convenience sampling was employed, the study population was drawn from a national tertiary referral center receiving patients from across Oman, which enhances the representativeness of the cohort. Consequently, the findings may be generalizable to the broader population of PLWH in Oman and may also provide useful insights for HIV programs in other Gulf Cooperation Council (GCC) countries with similar healthcare contexts. Nevertheless, caution should be exercised when extrapolating the findings to populations with different socio-demographic or healthcare characteristics.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAcquired Immune Deficiency Syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ecART\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCombined Antiretroviral Therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCD4\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCluster of Differentiation 4\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence Interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEuroSIDA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEuropean Study in Infections among Adults\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGCC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGulf Cooperation Council\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHBsAg\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHepatitis B Surface Antigen\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCV IgG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHepatitis C IgG Antibody\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman Immunodeficiency Virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHTN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIBM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInternational Business Machines\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMENA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMiddle East and North Africa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMREC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMedical Research Ethics Committee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePLWH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePeople Living with HIV\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRelative Risk\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTuberculosis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUAE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUnited Arab Emirates\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUNAIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Joint United Nations Programme on HIV/AIDS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by the Scientific Research Committee at the Royal Hospital, Ministry of Health, Oman (Approval No. MoH/CSR/24/28820). All patient data were anonymized, and confidentiality was maintained through de-identification using unique study codes; no personally identifiable information was accessed or disclosed.\u003c/p\u003e\n\u003cp\u003eFor the retrospective cohort (1992-26 August 2024), the ethics committee waived the requirement for written informed consent as data were obtained from de-identified hospital records. For the prospective cohort (27 August 2024 to 31 December 2024), patients were followed as part of routine clinical care. Data collection did not involve any direct patient contact or face-to-face interviews; all information was obtained exclusively from hospital electronic records (Shifa3+).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData is available upon reasonable request from:\u003c/p\u003e\n\u003cp\u003eDr. Faryal Khamis, Senior Consultant, Deputy Director, Directorate of Medicine, Head of Subspecialties, Royal Hospital, P.O. Box 1331, P.C.111, A’seeb, Oman. E-mail: [email protected]. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest. \u003cbr\u003e \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive any financial support for the research or publication of this article \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eZZ, YF, and FK formulated the study concept. ZZ, RA, and JN collected data. ZZ, YF, and RA cleaned data. ZZ and YF contributed to the literature review and manuscript write-up. ZZ, YF, AM, and RA conceptualized the methods. ZZ, YF, AM, RA, SJ, SS, and FK contributed to the review of the results. ZZ, YF, SJ, FK, AM, IM, and KA reviewed the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Royal Hospital, Ministry of Health, Oman, and University Medical City (Sultan Qaboos University) for their support in conducting this study. Special appreciation is extended to experts and colleagues from the Royal Hospital: Mr. Hassan Al-Lawati from hospital administration, Dr. Zakariya Al-Balushi and Dr. Saif Al-Abri from the Infectious Disease Unit, and Ms. Nuha Al-Rawahi and Ms. Wafa Al-Tamtami from the Nursing Department. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of AI-assisted technologies\u003c/strong\u003e\u003cbr\u003e During the preparation of this manuscript, the author used Grammarly software to assist with grammar, spelling, and sentence clarity.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAlwahibia, F., Al Ismaili, F., Haider, A., Al Kindi, M., Al Lawati, H., \u0026amp; Balkhair, A. (2025). Prevalence of Metabolic Diseases in HIV-Infected Patients Receiving Antiretroviral Therapy at Sultan Qaboos University Hospital, Oman. \u003cem\u003eIJID Regions\u003c/em\u003e, 100679.\u003c/li\u003e\n \u003cli\u003eAndrade, C. (2021). 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Censoring in clinical trials: Review of survival analysis techniques. \u003cem\u003eIndian Journal of Community Medicine\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(2), 217. https://doi.org/10.4103/0970-0218.66859\u003c/li\u003e\n \u003cli\u003eRao, S., Av, S., Unnikrishnan, B., Madi, D., \u0026amp; Shetty, A. K. (2018). Correlates of Late Presentation to HIV care in a South Indian Cohort. \u003cem\u003eThe American Journal of Tropical Medicine and Hygiene\u003c/em\u003e, \u003cem\u003e99\u003c/em\u003e(5), 1331\u0026ndash;1335. https://doi.org/10.4269/ajtmh.18-0386\u003c/li\u003e\n \u003cli\u003eRoyal Hospital- MOH. (2026). \u003cem\u003eRoyal Hospital Official Website\u003c/em\u003e [Dataset]. https://www.royalhospital.med.om/\u003c/li\u003e\n \u003cli\u003eTeshale, B. M., \u0026amp; Awoke, S. (2022). Survival analysis and predictors of mortality for adult HIV/AIDS patients following antiretroviral therapy in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: A retrospective cohort study. \u003cem\u003eHIV \u0026amp; AIDS Review\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 58\u0026ndash;68. https://doi.org/10.5114/hivar.2022.112758\u003c/li\u003e\n \u003cli\u003eThomas, R., Wang, W., \u0026amp; Su, D.-M. (2020). Contributions of Age-Related Thymic Involution to Immunosenescence and Inflammaging. \u003cem\u003eImmunity \u0026amp; Ageing\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(1). https://doi.org/10.1186/s12979-020-0173-8\u003c/li\u003e\n \u003cli\u003eTwabi, H. H., Ueno, A., Ives, J., Murtagh, R., Mukoka, M., Mortazavi, S. A., Lawrence, D. S., Choko, A. T., Semphere, R., Balakasi, K., Rangaraj, A., Ford, N., Jarvis, J. N., \u0026amp; MacPherson, P. (2026). Diagnostic accuracy of the WHO clinical staging system for detection of immunologically defined advanced HIV disease: A systematic review and meta‐analysis. \u003cem\u003eHIV Medicine\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(1), 120\u0026ndash;135. https://doi.org/10.1111/hiv.70122\u003c/li\u003e\n \u003cli\u003eUma, T., Srijayanth, P., Valarmathi, S., Sekar, S., Kabilan, N., \u0026amp; Natarajan, M. (2012). Socio-demographic profile of HIV/AIDS patients at ART centres in Chennai. \u003cem\u003eBMC Infectious Diseases\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(S1), P53, 1471-2334-12-S1-P53. https://doi.org/10.1186/1471-2334-12-S1-P53\u003c/li\u003e\n \u003cli\u003eUNAIDS. (2023). \u003cem\u003eGlobal HIV \u0026amp; AIDS statistics.\u003c/em\u003e .https://reliefweb.int/report/world/global-hiv-aids-statistics-fact-sheet\u003c/li\u003e\n \u003cli\u003eUNAIDS. (2024). \u003cem\u003eGlobal AIDS Update 2024. Https://www.unaids.org/en \u0026nbsp;Vaillant, A. A. J., \u0026amp; Gulick, P. G. (2022). HIV disease current practice. Stat Pearls [Internet]: Stat Pearls Publishing.\u003c/em\u003e https://www.unaids.org/en \u0026nbsp;Vaillant, A. A. J., \u0026amp; Gulick, P. G. (2022)\u003c/li\u003e\n \u003cli\u003eVassallo, M., Durant, J., Addou, S., Ticchioni, M., Fabre, R., Chirio, D., Naqvi, A., Cua, E., Ameil, L., Godemert, M., Pradier, C., \u0026amp; Carles, M. (2025). Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV. \u003cem\u003eFrontiers in Medicine\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 1562537. https://doi.org/10.3389/fmed.2025.1562537\u003c/li\u003e\n \u003cli\u003eWang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coates, M. M., Coggeshall, M., Dandona, L., Dicker, D. J., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Foreman, K., Forouzanfar, M. H., Fraser, M. S., \u0026hellip; Murray, C. J. L. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980\u0026ndash;2015: A systematic analysis for the Global Burden of Disease Study 2015. \u003cem\u003eThe Lancet\u003c/em\u003e, \u003cem\u003e388\u003c/em\u003e(10053), 1459\u0026ndash;1544. https://doi.org/10.1016/S0140-6736(16)31012-1\u003c/li\u003e\n \u003cli\u003eWHO. (2015). \u003cem\u003eMaximizing the treatment and prevention potential of antiretroviral drugs: Early country experiences towards implementing a treat-all policy: Programmatic update\u003c/em\u003e. JSTOR.\u003c/li\u003e\n \u003cli\u003eWorkie, K. L., Birhan, T. Y., \u0026amp; Angaw, D. A. (2021). Predictors of mortality rate among adult HIV-positive patients on antiretroviral therapy in Metema Hospital, Northwest Ethiopia: A retrospective follow-up study. \u003cem\u003eAIDS Research and Therapy\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(1), 27. https://doi.org/10.1186/s12981-021-00353-z\u003c/li\u003e\n \u003cli\u003eZrineh, A., Al‐Usta, M., \u0026amp; Alwawi, A. (2026). Sampling Methods and Sample Size Determination in Clinical Research: An Educational Review. \u003cem\u003eJournal of General and Family Medicine\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(1), e70096. https://doi.org/10.1002/jgf2.70096\u003cstrong\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV, AIDS, Mortality, Survival Analysis, Cox-Proportional Hazards Model, Cohort, Oman ","lastPublishedDoi":"10.21203/rs.3.rs-9490985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9490985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAcquired immunodeficiency syndrome (AIDS) remains a major global public health challenge despite substantial advances in combination antiretroviral therapy (cART). Understanding factors associated with mortality among people living with HIV/AIDS (PLWH) receiving cART is essential, particularly in settings such as Oman, where long-term epidemiological data remain limited. This study aimed to evaluate long-term survival and identify predictors of mortality among PLWH receiving cART in Oman over 32 years.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAn ambidirectional cohort study was conducted using data from the HIV/AIDS registry at the national tertiary referral hospital, the Royal Hospital in Oman, covering the period from January 1992 to December 2024. A total of 549 adult PLWH receiving cART were included. Clinical and laboratory data were extracted from electronic medical records and analyzed using descriptive statistics, Kaplan-Meier survival analysis, and multivariable Cox proportional hazards regression.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOut of 549 individuals diagnosed with HIV/AIDS in Oman, 99 deaths were recorded. Of these, 83 deaths were due to AIDS-related causes, while 16 were due to other reasons. The overall incidence rate of deaths was 1.5 per 1,000 person-months (95% CI: [1.21, 1.80]). In the adjusted Cox model, patients aged 18 to 27 (adjusted hazard ratio (AHR)\u0026thinsp;=\u0026thinsp;0.37, 95% CI: [0.16, 0.84]) and those aged 28 to 37 (AHR\u0026thinsp;=\u0026thinsp;0.31, 95% CI: [0.15, 0.63]) exhibited a significantly lower hazard of mortality compared to individuals aged 48 and older. Additionally, patients in WHO stage 1 (AHR\u0026thinsp;=\u0026thinsp;0.23, 95% CI: [0.09, 0.58]), stage 2 (AHR\u0026thinsp;=\u0026thinsp;0.23, 95% CI: [0.06, 0.86]), and stage 3 (AHR\u0026thinsp;=\u0026thinsp;0.39, 95% CI: [0.23, 0.64]) faced a reduced mortality risk in comparison to those with severe symptoms or stage 4. Low hemoglobin levels (\u0026lt;\u0026thinsp;10 g/dL) were associated with increased mortality (AHR\u0026thinsp;=\u0026thinsp;1.75, 95% CI: [1.09, 2.81]).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe overall mortality incidence rate was 1.5 per 1,000 person months. Younger age, earlier clinical stage at diagnosis, and normal hemoglobin levels were associated with improved survival among people living with HIV/AIDS receiving combination antiretroviral therapy in Oman. These findings emphasize the importance of early diagnosis, timely treatment initiation, and strengthened national HIV programs to reduce HIV/AIDS related mortality.\u003c/p\u003e","manuscriptTitle":"Long-Term Survival and Predictors of Mortality among Adults Living with HIV Receiving Combination Antiretroviral Therapy in Oman: An Ambidirectional Cohort Study, 1992-2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-23 09:35:23","doi":"10.21203/rs.3.rs-9490985/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-16T08:54:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"57482365223379224286419046031459276433","date":"2026-05-15T08:50:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"24150615145419402745969205988760489850","date":"2026-05-14T09:21:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"94671922243992465847244361526836308183","date":"2026-05-14T04:48:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-14T04:02:04+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-29T05:33:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-28T05:31:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-28T05:30:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2026-04-22T04:53:48+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"137bbe4f-8cf1-491d-b97d-28cb32b9b240","owner":[],"postedDate":"April 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-16T08:54:06+00:00","index":38,"fulltext":""},{"type":"reviewerAgreed","content":"57482365223379224286419046031459276433","date":"2026-05-15T08:50:26+00:00","index":35,"fulltext":""},{"type":"reviewerAgreed","content":"24150615145419402745969205988760489850","date":"2026-05-14T09:21:29+00:00","index":33,"fulltext":""},{"type":"reviewerAgreed","content":"94671922243992465847244361526836308183","date":"2026-05-14T04:48:27+00:00","index":32,"fulltext":""},{"type":"reviewersInvited","content":"8","date":"2026-05-14T04:02:04+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-14T04:08:46+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-23 09:35:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9490985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9490985","identity":"rs-9490985","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}