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Loss to Follow-up Trends in HIV-Positive Patients Receiving Antiretroviral Treatment in Asia From 2003 to 2013

Authors
 Nicole L. De La Mata  ;  Penh Sun Ly  ;  Kinh Van Nguyen  ;  Tuti Parwati Merati  ;  Thuy Thanh Pham  ;  Man Po Lee  ;  Jun Yong Choi  ;  Jeremy Ross  ;  Matthew G. Law  ;  Oon Tek Ng 
Citation
 JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol.74(5) : 555-562, 2017 
Journal Title
 JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES 
ISSN
 1525-4135 
Issue Date
2017
MeSH
Adult ; Aged ; Anti-Retroviral Agents/therapeutic use* ; Asia ; Female ; HIV Infections/drug therapy* ; HIV Infections/mortality ; Humans ; Incidence ; Lost to Follow-Up* ; Male ; Middle Aged ; Risk Assessment ; Young Adult
Abstract
INTRODUCTION: Over time, there has been a substantial improvement in antiretroviral treatment (ART) programs, including expansion of services and increased patient engagement. We describe time trends in, and factors associated with, loss to follow-up (LTFU) in HIV-positive patients receiving ART in Asia. METHODS: Analysis included HIV-positive adults initiating ART in 2003-2013 at 7 ART programs in Asia. Patients LTFU had not attended the clinic for ≥180 days, had not died, or transferred to another clinic. Patients were censored at recent clinic visit, follow-up to January 2014. We used cumulative incidence to compare LTFU and mortality between years of ART initiation. Factors associated with LTFU were evaluated using a competing risks regression model, adjusted for clinical site. RESULTS: A total of 8305 patients were included. There were 743 patients LTFU and 352 deaths over 26,217 person-years (pys), a crude LTFU, and mortality rate of 2.83 (2.64-3.05) per 100 pys and 1.34 (1.21-1.49) per 100 pys, respectively. At 24 months, the cumulative LTFU incidence increased from 4.3% (2.9%-6.1%) in 2003-05 to 8.1% (7.1%-9.2%) in 2006-09 and then decreased to 6.7% (5.9%-7.5%) in 2010-13. Concurrently, the cumulative mortality incidence decreased from 6.2% (4.5%-8.2%) in 2003-05 to 3.3% (2.8%-3.9%) in 2010-13. The risk of LTFU reduced in 2010-13 compared with 2006-09 (adjusted subhazard ratio = 0.73, 0.69-0.99). CONCLUSIONS: LTFU rates in HIV-positive patients receiving ART in our clinical sites have varied by the year of ART initiation, with rates declining in recent years whereas mortality rates have remained stable. Further increases in site-level resources are likely to contribute to additional reductions in LTFU for patients initiating in subsequent years.
Files in This Item:
T201705975.pdf Download
DOI
10.1097/QAI.0000000000001293
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161767
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