Factors associated with attrition, mortality, and loss to follow up after antiretroviral therapy initiation: data from an HIV cohort study in India
Open Access
- 12 September 2013
- journal article
- Published by Taylor & Francis Ltd in Global Health Action
- Vol. 6 (1), 21682
- https://doi.org/10.3402/gha.v6i0.21682
Abstract
Studies from sub-Saharan Africa have shown high incidence of attrition due to mortality or loss to follow-up (LTFU) after initiating antiretroviral therapy (ART). India is the third largest country in the world in terms of HIV infected people, but predictors of attrition after ART initiation are not well known. We describe factors associated with attrition, mortality, and LTFU in 3,159 HIV infected patients who initiated ART between 1 January 2007 and 4 November 2011 in an HIV cohort study in India. The study included 6,852 person-years with a mean follow-up of 2.17 years. After 5 years of follow-up, the estimated cumulative incidence of attrition was 37.7%. There was no significant difference between attrition due to mortality and attrition due to LTFU. Having CD4 counts P=0.19) after four years of follow-up. In this cohort study, the attrition was similar to the one found in sub-Saharan Africa. Earlier initiation of ART, improving the diagnosis of tuberculosis before initiating ART, and giving more support to those patients at higher risk of attrition could potentially reduce the mortality and LTFU after ART initiation.Keywords
This publication has 25 references indexed in Scilit:
- Toward an Understanding of Disengagement from HIV Treatment and Care in Sub-Saharan Africa: A Qualitative StudyPLoS Medicine, 2013
- Natural History and Factors Associated with Early and Delayed Mortality in HIV-Infected Patients Treated of Tuberculosis under Directly Observed Treatment Short-Course Strategy: A Prospective Cohort Study in IndiaInterdisciplinary Perspectives on Infectious Diseases, 2012
- Improved Retention Associated With Community-Based Accompaniment for Antiretroviral Therapy Delivery in Rural RwandaClinical Infectious Diseases, 2012
- HIV Treatment as Prevention: Systematic Comparison of Mathematical Models of the Potential Impact of Antiretroviral Therapy on HIV Incidence in South AfricaPLoS Medicine, 2012
- Universal Definition of Loss to Follow-Up in HIV Treatment Programs: A Statistical Analysis of 111 Facilities in Africa, Asia, and Latin AmericaPLoS Medicine, 2011
- Factors Influencing Retention in Care after Starting Antiretroviral Therapy in a Rural South African ProgrammePLOS ONE, 2011
- Patient retention in antiretroviral therapy programs up to three years on treatment in sub‐Saharan Africa, 2007–2009: systematic reviewTropical Medicine & International Health, 2010
- Mortality of Patients Lost to Follow-Up in Antiretroviral Treatment Programmes in Resource-Limited Settings: Systematic Review and Meta-AnalysisPLOS ONE, 2009
- High Mortality among Patients with AIDS Who Received a Diagnosis of Tuberculosis in the First 3 Months of Antiretroviral TherapyClinical Infectious Diseases, 2009
- Telemedicine in Rural IndiaPLoS Medicine, 2006