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. 2018 Nov 30:12:2545-2551.
doi: 10.2147/PPA.S180736. eCollection 2018.

Continuum of care among HIV-1 positive patients in a single center in Italy (2007-2017)

Filippo Lagi  1 , Seble Tekle Kiros  1 , Irene Campolmi  1 , Susanna Giachè  1 , Pier Giorgio Rogasi  2 , Marcello Mazzetti  2 , Filippo Bartalesi  2 , Michele Trotta  2 , Patrizia Nizzoli  3 , Alessandro Bartoloni  1   2 , Gaetana Sterrantino  2
Affiliations

Continuum of care among HIV-1 positive patients in a single center in Italy (2007-2017)

Filippo Lagi et al. Patient Prefer Adherence. .

Abstract

Aim: This study aimed to determine rates of retention in care, viral suppression, and use of antiretroviral therapy (ART) and identify risk factors for loss to follow-up (FU) in an adult cohort from a tertiary teaching hospital in Florence, Italy.

Methods: We included all newly diagnosed HIV-infected patients aged >18 years who were linked to our clinic from July 2007 to December 2015. On July 31, 2017, we evaluated the proportion of patients retained in care, on ART, and having HIV RNA <50 copies/mL. We assessed predictors of loss to FU through univariate and multivariate analyses.

Results: We included 423 patients. By July 2017, 23 (5.5%) patients died, 25 (5.9%) moved to a different center, and 64 (15.1%) were lost to follow-up. Among the remaining 311 patients (73.5%), 96.5% were on ART and 95% had HIV RNA <50 copies/mL. After adjustment for sex, age at diagnosis, origin, and risk of transmission, our results showed a lower retention rate in those not on ART at the end of the follow-up (adjusted HR [aHR]: 10.33, 95% CI 5.80-18.40, P<0.001), non-Italians (aHR: 1.69, 95% CI: 0.99-2.89, P=0.054) and <35 years old (aHR: 1.85; 95% CI 1.04-3.30, P=0.037).

Conclusion: In our hospital in Florence, we found a gap in retention in care among foreigners, people <35 years old, and those who were not in treatment at the end of the follow-up. The results of this study may help to identify opportunities for appropriate future interventions.

Keywords: 90-90-90 target; HIV-1; Italy; continuum of care; predictors associated to loss to follow-up; retention in care.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The cascade of continuum of care at AOUC, Florence, Italy. Abbreviations: AOUC, Azienda Ospedaliero – Universitaria Careggi; ART, antiretroviral treatment.
Figure 2
Figure 2
Kaplan–Meier plot: retention in care by nationality during a 10-year FU at AOUC, Florence, Italy. Abbreviations: FU, follow-up; AOUC, Azienda Ospedaliero – Universitaria Careggi.
Figure 3
Figure 3
Kaplan–Meier plot: retention in care by age at HIV diagnosis during a 10-year FU at AOUC, Florence, Italy. Abbreviations: FU, follow-up; AOUC, Azienda Ospedaliero – Universitaria Careggi.
See this image and copyright information in PMC

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