Brief Report: Mortality After Loss to Follow-Up-A Linkage Study of People Living With HIV in Thailand and Malaysia.
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
received:
20
02
2022
accepted:
15
07
2022
pubmed:
16
8
2022
medline:
20
10
2022
entrez:
15
8
2022
Statut:
ppublish
Résumé
Linkage studies have reported high rates of previously unascertained mortality among people living with HIV (PLHIV) who have been lost to follow-up (LTFU). We assessed survival outcomes among PLHIV who were LTFU in Thailand and Malaysia, through linkages to a national death registry or HIV database. Data linkages with the national death registry or national HIV database were conducted in 2020 on all PLHIV who met LTFU criteria while enrolled in care at participating HIV clinical sites. LTFU was defined as having no documented clinical contact in the previous year, excluding transfers and deaths. Survival time was analyzed using the Cox regression, stratified by site. Data linkages were performed for 489 PLHIV who had been LTFU at sites in Malaysia (n = 2) and Thailand (n = 4). There were 151 (31%) deaths after being LTFU; the mortality rate was 4.89 per 100 person-years. Risk factors for mortality after being LTFU were older age [41-50 years: hazard ratio (HR) = 1.99, 95% confidence interval (CI): 1.08 to 3.68; and older than 50 years: HR = 4.93, 95% CI: 2.63 to 9.22; vs. age 30 years or younger]; receiving NRTI + PI (HR = 1.87, 95% CI: 1.22 to 2.85 vs. NRTI + NNRTI); positive hepatitis C antibody (HR = 2.25, 95% CI: 1.40 to 3.62); and having previous AIDS illness (HR = 1.45, 95% CI: 1.03 to 2.05). An improved survival was seen with a higher CD4 count (CD4 351-500 cells/µL: HR = 0.40, 95%CI: 0.21-0.76; and CD4 >500 cells/µL: HR = 0.43, 95%CI: 0.25-0.75; vs. CD4 ≤200 cells/µL). Almost one-third of PLHIV who were LTFU in this cohort had died while out of care, emphasizing the importance of efforts to reengage PLHIV after they have been LTFU and ensure they have access to ongoing ART.
Sections du résumé
BACKGROUND
Linkage studies have reported high rates of previously unascertained mortality among people living with HIV (PLHIV) who have been lost to follow-up (LTFU). We assessed survival outcomes among PLHIV who were LTFU in Thailand and Malaysia, through linkages to a national death registry or HIV database.
METHODS
Data linkages with the national death registry or national HIV database were conducted in 2020 on all PLHIV who met LTFU criteria while enrolled in care at participating HIV clinical sites. LTFU was defined as having no documented clinical contact in the previous year, excluding transfers and deaths. Survival time was analyzed using the Cox regression, stratified by site.
RESULTS
Data linkages were performed for 489 PLHIV who had been LTFU at sites in Malaysia (n = 2) and Thailand (n = 4). There were 151 (31%) deaths after being LTFU; the mortality rate was 4.89 per 100 person-years. Risk factors for mortality after being LTFU were older age [41-50 years: hazard ratio (HR) = 1.99, 95% confidence interval (CI): 1.08 to 3.68; and older than 50 years: HR = 4.93, 95% CI: 2.63 to 9.22; vs. age 30 years or younger]; receiving NRTI + PI (HR = 1.87, 95% CI: 1.22 to 2.85 vs. NRTI + NNRTI); positive hepatitis C antibody (HR = 2.25, 95% CI: 1.40 to 3.62); and having previous AIDS illness (HR = 1.45, 95% CI: 1.03 to 2.05). An improved survival was seen with a higher CD4 count (CD4 351-500 cells/µL: HR = 0.40, 95%CI: 0.21-0.76; and CD4 >500 cells/µL: HR = 0.43, 95%CI: 0.25-0.75; vs. CD4 ≤200 cells/µL).
CONCLUSIONS
Almost one-third of PLHIV who were LTFU in this cohort had died while out of care, emphasizing the importance of efforts to reengage PLHIV after they have been LTFU and ensure they have access to ongoing ART.
Identifiants
pubmed: 35969472
doi: 10.1097/QAI.0000000000003067
pii: 00126334-202211010-00010
pmc: PMC9588686
mid: NIHMS1825504
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
290-295Subventions
Organisme : NIAID NIH HHS
ID : U01 AI069907
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
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:e0188488.
Mberi MN, Kuonza LR, Dube NM, et al. Determinants of loss to follow-up in patients on antiretroviral treatment, South Africa, 2004-2012: a cohort study. BMC Health Serv Res. 2015;15:259.
Ballif M, Christ B, Anderegg N, et al. Tracing people living with human immunodeficiency virus who are lost to follow-up at antiretroviral therapy programs in southern Africa: a sampling-based cohort study in 6 countries. Clin Infect Dis. 2022;74:171–179.
Vanobberghen F, Weisser M, Kasuga B, et al. Mortality rate in a cohort of people living with HIV in rural Tanzania after accounting for unseen deaths among those lost to follow-up. Am J Epidemiol. 2021;190:251–264.
McManus H, Petoumenos K, Brown K, et al. Loss to follow-up in the Australian HIV observational database. Antivir Ther. 2015;20:731–741.
Guy R, Wand H, McManus H, et al. Antiretroviral treatment interruption and loss to follow-up in two HIV cohorts in Australia and Asia: implications for 'test and treat' prevention strategy. AIDS patient care and STDs. 2013;27:681–691.
Teeraananchai S, Kerr SJ, Ruxrungtham K, et al. Loss to follow-up and associated factors of patients in the National AIDS Program in Thailand. Antivir Ther. 2018;23:529–538.
TAHOD A. Decade of combination antiretroviral treatment in Asia: the TREAT Asia HIV observational database cohort. AIDS Res Hum Retroviruses. 2016;32:772–781.
Zhou J, Kumarasamy N, Ditangco R, et al. The TREAT Asia HIV Observational Database: baseline and retrospective data. J Acquir Immune Defic Syndr. 2005;38:174–179.
World Health Organization. Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach. Geneva, Switzerland: World Health Organization; 2021.
Bisson GP, Gaolathe T, Gross R, et al. Overestimates of survival after HAART: implications for global scale-up efforts. PLoS One. 2008;3:e1725.
Brinkhof MWG, 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:e5790.
Wilkinson LS, Skordis-Worrall J, Ajose O, Ford N. Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis. Trop Med Int Health: TM IH. 2015;20:365–379.
Anderegg N, Hector J, Jefferys LF, et al. Loss to follow-up correction increased mortality estimates in HIV-positive people on antiretroviral therapy in Mozambique. J Clin Epidemiol. 2020;128:83–92.
Ambia J, Kabudula C, Risher K, et al. Outcomes of patients lost to follow-up after antiretroviral therapy initiation in rural north-eastern South Africa. Trop Med Int Health: TM IH. 2019;24:747–756.
Dewi K, Widiarta G. Predictors of mortality among patients lost to follow up antiretroviral therapy. Jurnal Ners. 2018;13:114–121.
Etoori D, Gomez-Olive FX, Reniers G, et al. Outcomes after being lost to follow-up differ for pregnant and postpartum women when compared with the general HIV treatment population in rural South Africa. J Acquir Immune Defic Syndr. 2020;85:127–137.
Angdembe MR, Rai A, Bam K, Pandey SR. Predictors of mortality in adult people living with HIV on antiretroviral therapy in Nepal: a retrospective cohort study, 2004-2013. PLoS One. 2019;14:e0215776.
Carriquiry G, Giganti MJ, Castilho JL, et al. Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort. J Int AIDS Soc. 2018;21:e25088.
World Health Organization. Scaling up Antiretroviral Therapy in Resource-Limited Settings: Treatment Guidlines for a Publich Health Approach. Geneva, Switzerland: World Health Organization; 2003.
World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infections. Recommendations for a Public Health Approach, 2nd ed. Geneva, Switzerland: World Health Organization; 2016.
Manosuthi W, Ongwandee S, Bhakeecheep S, et al. Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014, Thailand. AIDS Res Ther. 2015;12:12.
MoH Malaysia. Malaysian Concesus Guidelines on Antiretroviral Therapy. Malaysia: Ministry of Health; 2017.
Manosuthi W, Charoenpong L, Santiwarangkana C. A retrospective study of survival and risk factors for mortality among people living with HIV who received antiretroviral treatment in a resource-limited setting. AIDS Res Ther. 2021;18:71.
Chet LS, Hamid SAA, Bachok N, et al. Survival and prognostic factors of HIV-positive patients after antiretroviral therapy initiation at a Malaysian referral hospital. Saudi J Med Med Sci. 2021;9:135–144.