Introduction: Studies identified different determinants of survival which includes, viral load,rnWHO clinical staging, CD4 cell count, body mass index (BMI), total lymphocyte count (TLC),rnART adherence and baseline hemoglobin level. Even if these determinants of survival had beenrnidentified, there is no single proven model of determinants for predicting mortality of PLHIVrnand these determinants are dynamic and change over time due to improving quality of care andrnsupport and specific interventions like nutritional interventions. Furthermore, the optimal time tornstart treatment for HIV/AIDS has been a controversial issue since the introduction of HAART.rnObjective: To assess determinants of survival in patients living with HIV after starting ART.rnMethodology: A retrospective cohort study was conducted in Nekemte Referral Hospital. A totalrnof 416 patientsâ€™ records enrolled between 2005 to January, 2012 were reviewed consecutively byrnusing patientsâ€™ ART unique identification number as a reference. Univariate analysis was used torndescribe patientâ€™s baseline characteristics. Life table was used to estimate survival after initiationrnof ART, and log rank test was used to compare survival curves. Cox proportional-hazardrnregression was used to calculate the bivariate and adjusted hazard rate and then determinedrnindependent determinants of time to death.rnResults: Four hundred sixteen adult patients on ART were followed for a median of 47 months.rnThe mean age was 33.6 years (SD=9.04) and the median weight of the study subjects at therninitiation of ART was 51 kg (IQR, 45kg-58kg). The estimated mortality was 4%, 5%, 6%, 7%,rnand 7% at 6, 12, 24, 36 and 48 months respectively. After adjustment, factors such as, ageâ‰¥40rnAHR=3.364(1.211, 9.348, p=0.020), lower baseline hemoglobin level AHR=0.490 (0.300, 0.801,rnp=.007), and poor ART adherence AHR=132.3(29.9, 585.8, p