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Available literature on covariates of mortality relies on classical statistical methods that do not account for unmeasured variables (12). Potential unmeasured variables include 1) biological factors such as undiagnosed TB and/or other opportunistic infections such as cryptococcosis, 2) socio-economic factors that were not included in the data collection process, 3) healthcare-related factors, 4) adherence to HAART medication, and 5) cultural and religious beliefs. A study from Portugal assessed predictors of mortality in HIV-associated hospitalisations, and through frailty modelling, Steatosis it was shown how unmeasured variables in the form of quality in healthcare in different hospitals affected mortality (17). Hence, an assessment Selleckchem Pemetrexed that allows for the use of a mixed methods approach may provide an opportunity for further insight of the unmeasured variables that may qualify as risk factors. Underweight BMI was associated with mortality in both rural and urban areas with a slightly higher hazard in the urban group. Our findings concur with others from previous studies (5, 21, 29). While overweight or obese BMI was not associated with mortality in rural participants, it was associated with decreased mortality in the urban participants. Previous studies have shown that overweight or obese BMI reduces the risk of mortality (21). The proportion of participants with underweight BMI was higher in the rural group while that of overweight or obese participants was higher in the urban group suggesting differences in nutrition between the two groups. It may also be that the use of HAART mediated in the lack of association between mortality and overweight or obese BMI in the rural participants. Higher, most recent CD4 count was protective in both groups as similarly reported in previous studies (30, 31). However at enrolment, rural participants had a lower median CD4 count that qualified them to initiate therapy as per the treatment guidelines at the time. As in many treatment programmes across sub-Saharan Africa, first Abl kinase domain mutation time testers often present for care with low CD4 count. Previous studies have underscored the relationship between treatment initiation, low CD4 count, and early mortality (32�C35). Those on treatment for >6 months had a lower risk of mortality in the rural participants compared to >12 months in the urban participants. Among those on treatment for 6�C12 months in the urban participants, a greater proportion had a most recent CD4 count