BACKGROUND: The national antiretroviral therapy (ART) initiative in India began in 2004. In order to better inform the national program, we estimated the mean cumulative survival probability and loss to follow-up (LFU) rate among patients initiated on ART. METHODS: We identified a cohort of people living with HIV (PLHIV) aged ≥15 years initiated on ART in two ART centres in Hyderabad city, Andhra Pradesh state, India between January 2008 and December 2008. The cohort was followed-up until 31 December 2011 and death and/or LFU were the primary endpoints. Death from any cause during the study period was considered to be the result of HIV infection. We used the Kaplan-Meier estimation method for survival probability and Cox proportional hazard model to identify the predictors. RESULTS: Of the 1690 patients initiated on ART, 259 (15.3%) were transferred out during the study period. Mortality rate was 7.6/100 person-years. Male gender, low CD4 count, history of tuberculosis before initiation of ART, and weight <48 kg were the predictors of mortality. Patients who were LFU were more likely to be males, unemployed, widowed, and had weight below 48 kg. CONCLUSION: Survival rates on ART were higher compared to other resource-limited settings. Delayed diagnosis and initiation of ART and co-infection with TB were important predictors for both mortality and retention in care.
BACKGROUND: The national antiretroviral therapy (ART) initiative in India began in 2004. In order to better inform the national program, we estimated the mean cumulative survival probability and loss to follow-up (LFU) rate among patients initiated on ART. METHODS: We identified a cohort of people living with HIV (PLHIV) aged ≥15 years initiated on ART in two ART centres in Hyderabad city, Andhra Pradesh state, India between January 2008 and December 2008. The cohort was followed-up until 31 December 2011 and death and/or LFU were the primary endpoints. Death from any cause during the study period was considered to be the result of HIV infection. We used the Kaplan-Meier estimation method for survival probability and Cox proportional hazard model to identify the predictors. RESULTS: Of the 1690 patients initiated on ART, 259 (15.3%) were transferred out during the study period. Mortality rate was 7.6/100 person-years. Male gender, low CD4 count, history of tuberculosis before initiation of ART, and weight <48 kg were the predictors of mortality. Patients who were LFU were more likely to be males, unemployed, widowed, and had weight below 48 kg. CONCLUSION: Survival rates on ART were higher compared to other resource-limited settings. Delayed diagnosis and initiation of ART and co-infection with TB were important predictors for both mortality and retention in care.
Entities:
Keywords:
ART; HIV; India; Loss to follow-up; Survival analysis
Authors: Rakhi Dandona; Bharat B Rewari; G Anil Kumar; Sukarma Tanwar; S G Prem Kumar; Venkata S Vishnumolakala; Herbert C Duber; Emmanuela Gakidou; Lalit Dandona Journal: BMC Infect Dis Date: 2016-10-11 Impact factor: 3.090
Authors: Brian T Chan; Amrose Pradeep; Lakshmi Prasad; Vinothini Murugesan; Ezhilarasi Chandrasekaran; Nagalingeswaran Kumarasamy; Kenneth H Mayer; Alexander C Tsai Journal: J Glob Health Date: 2017-12 Impact factor: 4.413
Authors: Kelly V Ruggles; Anik R Patel; Stephen Schensul; Jean Schensul; Kimberly Nucifora; Qinlian Zhou; Kendall Bryant; R Scott Braithwaite Journal: PLoS One Date: 2017-09-05 Impact factor: 3.240