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Observational Study
. 2019 Aug;20(7):439-449.
doi: 10.1111/hiv.12734. Epub 2019 Apr 12.

Long-term loss to follow-up in the TREAT Asia HIV Observational Database (TAHOD)

A Jiamsakul  1 , S Kiertiburanakul  2 , O T Ng  3 , R Chaiwarith  4 , W Wong  5 , R Ditangco  6 , K V Nguyen  7 , A Avihingsanon  8 , S Pujari  9 , C D Do  10 , M-P Lee  11 , P S Ly  12 , E Yunihastuti  13 , N Kumarasamy  14 , A Kamarulzaman  15 , J Tanuma  16 , F Zhang  17 , J Y Choi  18 , P Kantipong  19 , Blh Sim  20 , J Ross  21 , M Law  1 , T P Merati  22 ; TREAT Asia HIV Observational Database of IeDEA Asia-Pacific
Collaborators, Affiliations
Observational Study

Long-term loss to follow-up in the TREAT Asia HIV Observational Database (TAHOD)

A Jiamsakul et al. HIV Med. 2019 Aug.

Abstract

Objectives: With earlier antiretroviral therapy (ART) initiation, time spent in HIV care is expected to increase. We aimed to investigate loss to follow-up (LTFU) in Asian patients who remained in care 5 years after ART initiation.

Methods: Long-term LTFU was defined as LTFU occurring after 5 years on ART. LTFU was defined as (1) patients not seen in the previous 12 months; and (2) patients not seen in the previous 6 months. Factors associated with LTFU were analysed using competing risk regression.

Results: Under the 12-month definition, the LTFU rate was 2.0 per 100 person-years (PY) [95% confidence interval (CI) 1.8-2.2 among 4889 patients included in the study. LTFU was associated with age > 50 years [sub-hazard ratio (SHR) 1.64; 95% CI 1.17-2.31] compared with 31-40 years, viral load ≥ 1000 copies/mL (SHR 1.86; 95% CI 1.16-2.97) compared with viral load < 1000 copies/mL, and hepatitis C coinfection (SHR 1.48; 95% CI 1.06-2.05). LTFU was less likely to occur in females, in individuals with higher CD4 counts, in those with self-reported adherence ≥ 95%, and in those living in high-income countries. The 6-month LTFU definition produced an incidence rate of 3.2 per 100 PY (95% CI 2.9-3.4 and had similar associations but with greater risks of LTFU for ART initiation in later years (2006-2009: SHR 2.38; 95% CI 1.93-2.94; and 2010-2011: SHR 4.26; 95% CI 3.17-5.73) compared with 2003-2005.

Conclusions: The long-term LTFU rate in our cohort was low, with older age being associated with LTFU. The increased risk of LTFU with later years of ART initiation in the 6-month analysis, but not the 12-month analysis, implies that there was a possible move towards longer HIV clinic scheduling in Asia.

Keywords: HIV; Asia; long term; lost to follow-up.

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Conflict of interest statement

Conflicts of Interest

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Time to loss to LTFU by year of ART initiation using: (a) 12-month definition of LTFU; and (b) 6-month definition of LTFU.
See this image and copyright information in PMC

References

    1. Cornell M, Lessells R, Fox MP, et al. Mortality among adults transferred and lost to follow-up from antiretroviral therapy programmes in South Africa: a multicenter cohort study. J Acquir Immune Defic Syndr. 2014;67(2):e67–75. - PMC - PubMed
    1. Brinkhof MW, Pujades-Rodriguez M, Egger M. Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis. PLoS One. 2009;4(6):e5790. - PMC - PubMed
    1. Jiamsakul A, Kariminia A, Althoff KN, et al. HIV Viral Load Suppression in Adults and Children Receiving Antiretroviral Therapy-Results From the IeDEA Collaboration. J Acquir Immune Defic Syndr. 2017;76(3):319–29. - PMC - PubMed
    1. Tweya H, Oboho IK, Gugsa ST, et al. Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi. PLoS One. 2018;13(1):e0188488. - PMC - PubMed
    1. Mberi MN, Kuonza LR, Dube NM, Nattey C, Manda S, Summers R. Determinants of loss to follow-up in patients on antiretroviral treatment, South Africa, 2004–2012: a cohort study. BMC health services research. 2015;15:259. - PMC - PubMed

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