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.
| Original language | English |
|---|---|
| Pages (from-to) | 439-449 |
| Number of pages | 11 |
| Journal | HIV Medicine |
| Volume | 20 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2019 Aug 1 |
Bibliographical note
Funding Information:The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of The Foundation for AIDS Research (amfAR), with support from the US National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Sydney. OTN was supported by the NMRC Clinician Scientist Award (NMRC/ CSA-INV/0002/2016). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.
Funding Information:
Ponnampalavanar and I. Azwa, University Malaya Medical Centre, Kuala Lumpur, Malaysia; R. Ditangco*, M. K. Pasayan and M. L. Mationg, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; W. W. Wong*, W. W. Ku and P. C. Wu, Taipei Veterans General Hospital, Taipei, Taiwan; O. T. Ng*,‡, P. L. Lim, L. S. Lee and Z. Ferdous, Tan Tock Seng Hospital, Singapore; A. Avihingsanon*, S. Gatechompol, P. Phanuphak and C. Phadungphon, HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; S. Kiertiburanakul*, A. Phu-phuakrat, L. Chumla and N. Sanmeema, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; R. Chaiwarith*, T. Sirisanthana, W. Kotarathiti-tum and J. Praparattanapan, Research Institute for Health Sciences, Chiang Mai, Thailand; S. Khusuwan*, P. Kan-tipong and P. Kambua, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; K. V. Nguyen*, H. V. Bui, D. T. H. Nguyen and D. T. Nguyen, National Hospital for Tropical Diseases, Hanoi, Vietnam; C. D. Do*, A. V. Ngo and L. T. Nguyen, Bach Mai Hospital, Hanoi, Vietnam; A. H. Sohn*, J. L. Ross* and B. Petersen, TREAT Asia, The Foundation for AIDS Research (amfAR), Bangkok, Thailand; M. G. Law*, A. Jiamsakul* and D. Rupasinghe, The Kirby Institute, UNSW Sydney, NSW, Australia. *TAHOD Steering Committee member; †Steering Committee Chair; ‡Co-Chair.
Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of The Foundation for AIDS Research (amfAR), with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Sydney. OTN was supported by the NMRC Clinician Scientist Award (NMRC/CSA-INV/0002/2016). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Conflicts of interest: There are no conflicts of interest.
Publisher Copyright:
© 2019 British HIV Association
All Science Journal Classification (ASJC) codes
- Health Policy
- Infectious Diseases
- Pharmacology (medical)
