Baseline and Process Factors of Anti-Retroviral Therapy That Predict Loss to Follow-up Among People Living with HIV/AIDS in China: A Retrospective Cohort Study

A retrospective cohort study was conducted to explore the effectiveness of Traditional Chinese Medicine (TCM) in treating people living with HIV (PLHIV) by comparing the survival of PLHIV treated with TCM and without TCM. To identify prognostic factors that affect the survival of PLHIV, patients who enrolled in the national TCM HIV treatment trial program (NTCMTP) in October 2004 and PLHIV in the same region who did not enroll in the NTCMTP were compared. Participants were followed up to October 2012. Survival time was estimated through the Kaplan–Meier method, and hazard ratios to identify prognostic factors were computed through Cox proportional hazard models. A total of 3,229 PLHIV (1,442 in the TCM therapy group and 1,787 in the non-TCM therapy group) were followed up for 21,876 person-years. In this time period, 751 (23.3%) died and 209 (6.5%) were lost to follow-up, for an overall mortality rate of 3.43/100 person-years. In the TCM therapy group, 287 (19.0%) died and 139 (9.7%) were lost to follow-up, and in the non-TCM therapy group, 464 (26.0%) PLHIV died and 70 (3.9%) were lost to follow-up. The mortality rate in the TCM therapy group was 2.97/100 person-years, which was lower than the rate of 3.79/100 person-years in the non-TCM therapy group. The 8-year cumulative survival in the TCM therapy group was 78.5%, lower than the 74.0% survival in the non-TCM therapy group. After adjusting for other factors, risk factors of death included male gender, older age, less education, taking combined antiretroviral therapy (cART) at enrollment, not taking cART at follow-up, and lower CD4 + T cell counts. Our retrospective cohort study indicates that TCM increased the survival and lengthened the lifetime of PLHIV in Henan Province of China. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results.

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Retrospective cohort study of statin prescribing for primary prevention among people living with HIV

JRSM Cardiovascular Disease ◽

10.1177/20480040211031068 ◽

2021 ◽

Vol 10 ◽

pp. 204800402110310

Author(s):

Joseph A Nardolillo ◽

Joel C Marrs ◽

Sarah L Anderson ◽

Rebecca Hanratty ◽

Joseph J Saseen

Keyword(s):

Cohort Study ◽

Primary Prevention ◽

Statin Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

People Living With Hiv ◽

Intermediate Risk ◽

Electronic Health Record Data ◽

Hiv Patients ◽

Living With Hiv

Objective To compare statin prescribing rates between intermediate-risk people living with human immunodeficiency virus (HIV; PLWH) and intermediate-risk patients without a diagnosis of HIV for primary prevention of atherosclerotic cardiovascular disease (ASCVD). Methods Retrospective cohort study . Electronic health record data were used to identify a cohort of PLWH aged 40–75 years with a calculated 10-year ASCVD risk between 7.5%-19.9% as determined by the Pooled Cohort Equation (PCE). A matched cohort of primary prevention non-HIV patients was identified. The primary outcome was the proportion of PLWH who were prescribed statin therapy compared to patients who were not living with HIV and were prescribed statin therapy Results 81 patients meeting study criteria in the PLWH cohort were matched to 81 non-HIV patients. The proportion of patients prescribed statins was 33.0% and 30.9% in the PLWH and non-HIV cohorts, respectively (p = 0.74). Conclusion and relevance: This study evaluated statin prescribing in PLWH for primary prevention of ASCVD as described in the 2018 AHA/ACC/Multisociety guideline. Rates of statin prescribing were similar, yet overall low, among intermediate-risk primary prevention PLWH compared to those not diagnosed with HIV.

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Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda

PLoS ONE ◽

10.1371/journal.pone.0217606 ◽

2020 ◽

Vol 15 (4) ◽

pp. e0217606 ◽

Cited By ~ 1

Author(s):

Julius Kiwanuka ◽

Jacinta Mukulu Waila ◽

Methuselah Muhindo Kahungu ◽

Jonathan Kitonsa ◽

Noah Kiwanuka

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hiv Positive ◽

Loss To Follow Up ◽

Test And Treat

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The incidence of stroke among patients undergoing elective posterior lumbar fusion: a retrospective cohort study

10.21203/rs.2.17730/v1 ◽

2019 ◽

Author(s):

Patrick Arena ◽

Jingping Mo ◽

Charu Sabharwal ◽

Elizabeth Begier ◽

Xiaofeng Zhou ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Lumbar Fusion ◽

Index Hospitalization ◽

Loss To Follow Up ◽

Posterior Lumbar Fusion ◽

Electronic Healthcare Record ◽

Post Operation

Abstract Background: Although stroke is an uncommon but life-threatening complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among adults undergoing elective posterior lumbar fusion (PLF) during post-operative risk windows and among different subgroups. Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. Incidence proportions (IPs) and rates (IRs) of stroke were estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operation Results: A total of 43,063 patients were eligible for the study. The IP of stroke following elective PLF ranged from 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization to 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation; the IR of stroke following elective PLF per 1000 person-years decreased consistently from 229.08 (95% CI: 192.38, 272.78) during index hospitalization to 13.68 (95% CI: 12.51, 14.96) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences than white, Asian, or other patients. Furthermore, the incidence of post-operative stroke was higher among patients with a history of type 2 diabetes than among patients without such history. Conclusions: The incidence of stroke following elective PLF found here using an EHR database is slightly higher than that reported in the literature; however, the discrepancy is due to differences in the variable definitions, study populations, follow-up periods, and data sources between our study and those in the literature.

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Malaria and intestinal parasite co-infection and its association with anaemia among people living with HIV in Buea, Southwest Cameroon: A community-based retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0245743 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245743

Author(s):

Sorelle Mekachie Sandie ◽

Irene Ule Ngole Sumbele ◽

Martin Mih Tasah ◽

Helen Kuokuo Kimbi

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Intestinal Parasites ◽

Significant Risk ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Community Based ◽

Living With Hiv ◽

Hiv Negative

Background Both malaria and intestinal parasites are endemic in Cameroon, and their co-infection can be of great impact on anaemia among people living with HIV (PLWH). This community-based retrospective cohort study determined the prevalence and association of infections with anaemia in PLWH and HIV-negative individuals in Buea, Cameroon from March to August 2019. Methods The study population comprised of 190 PLWH and 216 consenting HIV-negative individuals from the Buea community. Participants were examined clinically, the collected blood sample was used for malaria parasite (MP) detection, HIV diagnosis and haemoglobin (Hb) measurement while stool samples were examined for the detection of intestinal parasites (IPs). Proportions were compared using Pearson’s Chi-square test and association of anaemia with independent variables was evaluated using logistic regression analysis. Results Out of the 406 participants, MP, IPs and MP/IP co-infection prevalences were 15.5%, 13.0% and 3.0% respectively. PLWH had a higher prevalence of MP (16.3%, P = 0.17), IPs (23.7%, P ˂ 0.001) and MP/IPs co-infection (3.7%, P = 0.04) when compared with HIV-negative participants. Similarly, PLWH had significantly lower mean haemoglobin value (11.10 ± 1.54 g/dL) than their HIV-negative counterparts (12.45 ± 2.06 g/dL). Also, PLWH co-infected with MP and IPs were observed to have a significantly lower mean haemoglobin value (10.6 ± 1.21 g/dL). PLWH had a significantly (P ˂ 0.001) higher prevalence of mild (56.8%), moderate (18.4%) and severe (1.6%) anaemia when compared with HIV-negative counterparts. The significant risk factors associated with anaemia included being febrile (P = 0.03), MP-infected only (P = 0.001), HIV-infected only (P < 0.001), having dual (P < 0.001) or triple-infections (P = 0.03). Conclusion Malaria and intestinal parasites remain public health concerns among PLWH and anaemia as a serious haematological abnormality gets exacerbated even with the viral load suppression. Hence, routine medical check-ups among PLWH are recommended.

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