BACKGROUND: The introduction of highly active antiretroviral therapy in 1996 dramaticallyrnimproved survival and quality of HIV-infected patients in the industrialized world. This survivalrnbenefit of HAART in HIV infection has been well studied in the developed world. In resource-poorrnsettings, where such treatment was started only recently, limited data exist on treatment results. Morernover mortality have been high particularly in the first month of initiating ART and factorsrncontributing to this high mortality are poorly understood.rnOBJECTIVE: To asses predictors of survival in PLWHA after the advent of HAART.rnMETHODS: A historical cohort study was conducted in Zewditu Hospital located in Addis Ababa,rnEthiopia. Patientâ€™s records enrolled between March, 2005 to July, 2008 were reviewed consecutivelyrnusing patients ART unique identification number as a reference. Different documents for the samernpatient were triangulated in case of odd values, non logical or missed data. Deaths from all AIDSrnrelated cause occurring during the follow-up period were identified from physician reports orrnregistration by drug adherence counselor. Univariate analysis was used to describe patientâ€™s baselinerncharacteristics. Actuarial table was used to estimate survival after intiation of ART, and log rank testrnwas used to compare survival curves. Cox proportional-hazard regression was used to calculate thernbivariate and adjusted hazard rate and then determine independent predictors of time to death.rnRESULT; One thousand seventy patients on ART were followed for a median of 34 month (IQR 6,rn36.25). The mean age was 36.4 and the median weight of the cohort at the initiation of ART wasrn51kg (IQR, 45-60kg).The median CD4 count was 94cells/Î¼l (IQR, 46-154). The estimated mortalityrnwas 24.9%, 29%, 31.7%, 33.1%, 33.5, and 34% at 6, 12, 18, 30, and 48 months respectively. Afterrnadjustment, the independent significant predictors of not surviving in patients living with HIV/AIDSrnafter initiation of ART remain poor ART adherence (AHR=3.92[95%CI=3.13, 4.90]),AdvancedrnWHO staging (AHR=2.47[95%CI= (1.58, 3.81]), being unemployed (AHR=1.87[95%CI= 1.49,rn2.34]), moderate anemia (AHR=1.86[95%CI=1.35, 2.56), and Low CD4 count (AHR=1.85[95%CI=rn1.35, 2.52]).rnCONCLUSION; A careful monitoring of patients with low CD4+ ,advanced WHO staging,rnmoderate anemia and unemployed particularly during the first 3 months of HAART is necessary.rnTracing poorly adhered patients and giving them drug counseling is crucial to improve their survival.