A Touré1, D Cissé2, Kjjo Kadio2, A Camara2, F A Traoré3, A Delamou2, S Sididé2, C Kouyaté4, I S Bangoura4, M M Diallo5, T M Tounkara6, F Traoré7, M S Sow3, N Khanafer8, M Cissé6. 1. Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée. Electronic address: abdoulayek2002@yahoo.fr. 2. Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée. 3. Service de maladies infectieuses et tropicales, hôpital national Donka, Conakry, Guinée. 4. Association des femmes de Guinée pour la lutte contre les IST et le sida (ASFEGMASSI), Guinée. 5. Solidarité thérapeutique et initiative pour la santé (Solthis), Guinée. 6. Service de dermatologie-vénérologie-MST, hôpital national Donka, Conakry, Guinée. 7. Institut national de santé publique, Conakry, Guinée. 8. Epidemiology and Infection Control Unit, Edouard-Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France.
Abstract
BACKGROUND: Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry. METHODS: A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS: 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/μL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/μL. CONCLUSION: Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.
BACKGROUND: Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIVpatients who receiving antiretroviral therapy at Conakry. METHODS: A retrospective cohort study was conducted in HIVpatients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS: 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/μL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/μL. CONCLUSION: Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.
Authors: A Jiamsakul; S Kiertiburanakul; O T Ng; R Chaiwarith; W Wong; R Ditangco; K V Nguyen; A Avihingsanon; S Pujari; C D Do; M-P Lee; P S Ly; E Yunihastuti; N Kumarasamy; A Kamarulzaman; J Tanuma; F Zhang; J Y Choi; P Kantipong; Blh Sim; J Ross; M Law; T P Merati Journal: HIV Med Date: 2019-04-12 Impact factor: 3.180