scholarly journals Viral Suppression and Loss To Follow Up in HIV/AIDS Patients on Antiretroviral Therapy in Pakistan

2018 ◽  
Vol 73 ◽  
pp. 249
Author(s):  
M.Z.K. Assir ◽  
F. Ahmad ◽  
S.H. Riaz ◽  
A. Adil ◽  
T. Rashid
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Aids Patients ◽  
Loss To Follow Up ◽  
Hiv Aids

scholarly journals The HIV care cascade for adolescents initiated on antiretroviral therapy in a health district of South Africa: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roxanna Haghighat ◽  
Elona Toska ◽  
Nontuthuzelo Bungane ◽  
Lucie Cluver
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Hiv Care ◽  
Loss To Follow Up ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Clinical Records

Abstract Background Little evidence exists to comprehensively estimate adolescent viral suppression after initiation on antiretroviral therapy in sub-Saharan Africa. This study examines adolescent progression along the HIV care cascade to viral suppression for adolescents initiated on antiretroviral therapy in South Africa. Methods All adolescents ever initiated on antiretroviral therapy (n=1080) by 2015 in a health district of the Eastern Cape, South Africa, were interviewed in 2014–2015. Clinical records were extracted from 52 healthcare facilities through January 2018 (including records in multiple facilities). Mortality and loss to follow-up rates were corrected for transfers. Predictors of progression through the HIV care cascade were tested using sequential multivariable logistic regressions. Predicted probabilities for the effects of significant predictors were estimated by sex and mode of infection. Results Corrected mortality and loss to follow-up rates were 3.3 and 16.9%, respectively. Among adolescents with clinical records, 92.3% had ≥1 viral load, but only 51.1% of viral loads were from the past 12 months. Adolescents on ART for ≥2 years (AOR 3.42 [95%CI 2.14–5.47], p< 0.001) and who experienced decentralised care (AOR 1.39 [95%CI 1.06–1.83], p=0.018) were more likely to have a recent viral load. The average effect of decentralised care on recent viral load was greater for female (AOR 2.39 [95%CI 1.29–4.43], p=0.006) and sexually infected adolescents (AOR 3.48 [95%CI 1.04–11.65], p=0.043). Of the total cohort, 47.5% were recorded as fully virally suppressed at most recent test. Only 23.2% were recorded as fully virally suppressed within the past 12 months. Younger adolescents (AOR 1.39 [95%CI 1.06–1.82], p=0.017) and those on ART for ≥2 years (AOR 1.70 [95%CI 1.12–2.58], p=0.013) were more likely to be fully viral suppressed. Conclusions Viral load recording and viral suppression rates remain low for ART-initiated adolescents in South Africa. Improved outcomes for this population require stronger engagement in care and viral load monitoring.

scholarly journals The role of SEAD project intervention in viral suppression of HIV/AIDS patients with follow-up and adherence barriers

2012 ◽  
Vol 15 (6(Suppl 4)) ◽  
Author(s):  
L Elías Casado ◽  
M Pérez Elías ◽  
D López Pérez ◽  
M Pumares Álvarez ◽  
M Martinez-Colubi ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Aids Patients ◽  
Project Intervention ◽  
Hiv Aids

scholarly journals Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

2021 ◽  
Author(s):  
Pepukai Bengura
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Viral Load ◽  
Marital Status ◽  
Art Adherence ◽  
Aids Patients ◽  
Loss To Follow Up ◽  
Generalized Gamma ◽  
Hiv Aids

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.

Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

2021 ◽  
Author(s):  
Pepukai Bengura
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Viral Load ◽  
Marital Status ◽  
Art Adherence ◽  
Aids Patients ◽  
Loss To Follow Up ◽  
Generalized Gamma ◽  
Hiv Aids

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.

scholarly journals Factors of Loss to Follow-up Antiretroviral Therapy in Islanded Area

2018 ◽  
Vol 7 (2) ◽  
pp. 98-103
Author(s):  
Thomas Laga Boro ◽  
Rafael Paun ◽  
Marthen R Pellokila
Keyword(s):  
Antiretroviral Therapy ◽  
Self Efficacy ◽  
Random Sampling ◽  
Public Hospital ◽  
Simple Random Sampling ◽  
Case Control ◽  
People Living With Hiv ◽  
Loss To Follow Up ◽  
Hiv Aids

ABSTRACT Loss to follow-up of antiretroviral therapy is when PLWHA (People Living with HIV/AIDS) do not come for antiretroviral therapy for more than 3 months. This study aimed to determine the factors of loss to follow-up antiretroviral therapy for PLWHA at Prof. Dr. W. Z. Johannes Kupang Public Hospital where PLWHA with land, water and air transportation are served. This was a case control study with 66 samples of PLWHA. The samples underwent antiretroviral therapy in Prof. Dr.W.Z. Johannes Kupang Public Hospital from 2006 to 2016. Saturated sampling technique was done for cases group and simple random sampling was done for control group. Univariate and bivariate data analysis were done in this study. The result of bivariate analysis showed that there were association between intention (p = 0.004, OR = 4.667), self efficacy (p = 0.0001, OR = 7.875), action (p = 0.0001, OR = 45.000), transportation mode (p = 0.046, OR = 0.200), and transport costs (p = 0.0001, OR 19.333) and loss to follow-up antiretroviral therapy. It could be concluded that transportation and behavior were the major problems for the loss to follow up antiretroviral therapy in the islanded area.   Keywords: HIV/AIDS, antiretroviral therapy, loss to follow-up, islanded area   ABSTRAK Gagal follow-up antiretroviral therapy adalah  jika ODHA (Orang dengan HIV/AIDS) tidak menjalani terapi antireroviral lebih dari 3 bulan  terakhir. Penelitian ini bertujuan untuk mengetahui faktor-faktor gagal follow-up antiretroviral therapy pada ODHA di RSUD Prof. Dr. W. Z. Johannes Kupang yang melayani para ODHA dengan moda transportasi darat, air, dan udara. Desain penelitian ini adalah case control. Sampel sebanyak 66 ODHA yang menjalani antiretroviral therapy di RSUD Prof. Dr.W.Z. Johannes Kupang sejak tahun 2006 sampai 2016. Teknik pengambilan sampel yang digunakan adalah sampel jenuh untuk kelompok kasus dan simple random sampling untuk kelompok kontrol. Analisis data menggunakan prosentase untuk univariat dan bivariat. Hasil analisis bivariat menunjukkan ada pengaruh niat (p = 0,004, OR = 4,667), self efficacy (p = 0,0001, OR = 7,875), tindakan (p = 0,0001, OR = 45,000), moda transportasi (p = 0,046, OR = 0,200), dan biaya transportasi (p = 0,0001, OR 19,333) terhadap gagal  follow up terapi antiretroviral. Dapat disimpulkan bahwa masalah utama gagal follow up terapi antiretroviral di wilayah berkepulauan ini adalah transportasi dan perilaku.   Kata Kunci: HIV/AIDS,  terapi antiretroviral, gagal follow up, wilayah berkepulauan.

KARAKTERISTIK KLINIS PASIEN YANG MENERIMA TERAPI ARV DI RSUD KABUPATEN BULELENG

2020 ◽  
Vol 6 (2) ◽  
pp. 212-216
Author(s):  
I Gusti Ngurah Putu Candra ◽  
Dewi Aprelia Meriyani ◽  
Luh Putu Desy Puspaningrat ◽  
Yopita Triguno ◽  
Ni Kadek Ayu Tamara Widya Sari
Keyword(s):  
Loss To Follow Up ◽  
Hiv Aids

  ABSTRAK Latar Belakang Penyakit menular yang selalu memberikan dampak tidak hanya kesehatan tetapi social dan ekomoni adalha HIV/AIDS.Tujuan untuk mendeskripsikan kondisi klinis dan dmeografi pasien yang menerima terapi ARV.MetodePenelitian deskriptif dengan pendekatan secara kohort retrospektifmenggunakan data sekunder dari register kohort ARV dari tahun 2005-2015 (11 tahun terapi ARV). Analisis yang digunakan adalah analisis univariat menggunakan SPSS versi 17.Hasil Karakteristik klinis dan demografi pada odha yang menerima terapi ARV yaitu 45,32% dalam kondisi ambulatory, 75.42% mendapatkan regimen NNRTI jenis zidovudine, 75.82 % mendapatkan terapi regimen NRTI nevirapine, 79.66% pada kondisi stadium 3 dan 4, dengan klasifikasi umur produktif (< 40 tahun sebanyak 82.05%, sebagian besar berjenis kelamin laki-laki 62.96%, dan memiliki pengawas minum obat (PMO) sebesar 68.25%. Proporsi kematian sebesar  9.3 % (112 orang), LTFU (loss to follow up) 18.52% (223 orang), subsitusi regimen lini satu 9.88% (119 orang),rujuk keluar 1.83% (22 orang) dan yang masih dalam pengobatan sebesar 69.93% (842).Kesimpulan Pasien yang mengalami LTFU terbagi dalam beberapa kondisi yaitu LTFU dalam kondisi meninggal 3.07% (37 orang), LTFU dalam kondisi hidup 0.5% (6 orang), dan LTFU yang tidak diketahui kondisinya sebesar 14.95% (180 orang).Saran Monitoring dan evaluasi pada program pengobatan dilakukan secara berkelanjutan untuk meningkatkan konsistensi terapi yang dilakukan.  Kata Kunci : Karakteristik, Terapi, HIV/AIDS 

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