scholarly journals Re-engagement in care of people living with HIV lost to follow-up after initiation of antiretroviral therapy in Mali: Who returns to care?

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0238687
Author(s):  
Aliou Baldé ◽  
Laurence Lièvre ◽  
Almoustapha Issiaka Maiga ◽  
Fodié Diallo ◽  
Issouf Alassane Maiga ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Engagement In Care ◽  
Living With Hiv ◽  
Lost To Follow Up

scholarly journals Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania

HIV Medicine ◽  
2021 ◽  
Author(s):  
Robert C. Ndege ◽  
James Okuma ◽  
Aneth V. Kalinjuma ◽  
Julius Mkumbo ◽  
Elizabeth Senkoro ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Rural Tanzania ◽  
Living With Hiv ◽  
Lost To Follow Up

scholarly journals Survival analysis of people living with human immunodeficiency virus: a study in a teaching hospital

2020 ◽  
Vol 7 (9) ◽  
pp. 1339
Author(s):  
S. Bhagyabati Devi ◽  
T. Jeetenkumar Singh ◽  
Kshetrimayum Birendra Singh ◽  
N. Biplab Singh ◽  
Robinson Ningshen ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Good Adherence ◽  
National Programme ◽  
Immunodeficiency Virus ◽  
Centre Of Excellence ◽  
High Incidence ◽  
Good Nutrition ◽  
Living With Hiv

Background: Antiretroviral therapy (ART) have changed the outlook of people living with HIV (PLHIV) by transforming the dreaded infection to a chronically manageable disease. However, there is scant of reports which analyses quantitatively the survival benefit of PLHIV under ART. Objectives of this study were to determine the survival time of adult PLHIV who are on ARV. To analyse the factors determining survival outcome of PLHIV on ARV.Methods: This was an observational study in centre of excellence (COE) ART Centre, RIMS, Imphal from April 2004 to December 2009. Details from the data entered in documents of the ART programme were followed up every 3 months for 60 months from the date of initiation of ARV. All PLHIV above 18 years of age and undergoing antiretroviral therapy were included.Results: Survival rate following initiation of ARV was found to be significantly high among PLHIV. Higher CD4 count at the time of ARV initiation had better prognosis. Mortality was high among IDUs and they had high incidence of co-infections with HCV and HBV. The currently available ARV drugs under NACO programme have better suppression of HIV, are less toxic, low pill burden. The combined regimen used in the earlier days were not much inferior to the current ARV drugs if initiated timely with proper prophylaxis of OIs, good adherence, good nutrition and timely management of toxicities and IRIS.Conclusions: Timely treatment with ARV drugs provided under the national programme with good adherence and regular follow-up improves the survival of PLHIV.  

scholarly journals Does undernutrition increase the risk of lost to follow-up in adults living with HIV in sub-Saharan Africa? Protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048022
Author(s):  
Animut Alebel ◽  
Daniel Demant ◽  
Pammla Petrucka ◽  
David Sibbritt
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Significance Level ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Lost To Follow Up

IntroductionUndernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m2) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA.Methods and analysisPubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I2 statistics. The Egger’s and Begg’s tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI.Ethics and disseminationEthical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42021277741.

scholarly journals Predictors of Mortality among Patients Lost to Follow up Antiretroviral Therapy

Jurnal NERS ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 114 ◽  
Author(s):  
Putu Dian Prima Kusuma Dewi ◽  
Gede Budi Widiarta
Keyword(s):  
Incidence Rate ◽  
Median Time ◽  
Secondary Data ◽  
Primary Data ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Living With Hiv ◽  
Lost To Follow Up

Introduction: The death of HIV/AIDS patients after receiving therapy in Bali is the seventh highest percentage of deaths in Indonesia. LTFU increases the risk of death in PLHA, given the saturation of people with HIV taking medication. The level of consistency in the treatment is very important to maintain the resilience and quality of life of people living with HIV. This study aims to determine the incidence rate, median time and predictors of death occurring in LTFU patients as seen from their sociodemographic and clinical characteristics.Methods: This study used an analytical longitudinal approach with retrospective secondary data analysis in a cohort of HIV-positive patients receiving ARV therapy at the Buleleng District Hospital in the period 2006-2015. The study used the survival analysis available within the STATA SE 12 softwareResults: The result showed that the incidence rate of death in LTFU patients was 65.9 per 100 persons, with the median time occurrence of 0.2 years (2.53 months). The NNRTI-class antiretroviral evapirens agents were shown to increase the risk of incidence of death in LTFU patients 3.92 times greater than the nevirapine group (HR 3.92; p = 0.007 (CI 1.46-10.51). Each 1 kg increase in body weight decreased the risk of death in LTFU patients by 6% (HR 0.94; p = 0.035 (CI 0.89-0.99).Conclusion: An evaluation and the monitoring of patient tracking with LTFU should be undertaken to improve sustainability. Furthermore, an observation of the LTFU patient's final condition with primary data and qualitative research needs to be done so then it can explore more deeply the reasons behind LTFU.

scholarly journals 1319. Events of Disengagement from HIV care and Subsequent Reengagement in a Kenyan Pastoralist Community: Frequency, Determinants, and Patient Views

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S476-S477
Author(s):  
Paul Otieno Yonga ◽  
Stephen Kiplimo Kalya ◽  
Lutgarde Lynen ◽  
Tom Decroo
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Hospital Admissions ◽  
Hiv Care ◽  
Engagement In Care ◽  
Work Related ◽  
Medication Side ◽  
Competing Priorities ◽  
Lost To Follow Up

Abstract Background Regular follow-up HIV-infected patients on antiretroviral therapy (ART) is vital to ensure viral suppression, thus reducing HIV transmission, and HIV-related morbidity and mortality. However, some patients have been reported to have events of disengagement from care with subsequent re-engagement in care, though knowledge on the magnitude and determinants of this phenomenon, particularly in pastoralist communities is scarce. Methods A mixed-methods study was carried out among HIV-infected patients on antiretroviral therapy (ART) follow-up between January 2014 and June 2017 at the Baringo County Referral Hospital, Kabarnet, Kenya. Records on their clinic attendance and laboratory follow-up were extracted, and those noted to have a recent event of disengagement from care who later re-engaged in care, were then purposively sampled for in-depth interviews. Results 342 patient records were analyzed, of which 48% (166/342) of the patients were noted to be active at the end of the study period, with 63.3% (105/166) of them noted to have one or more events of disengagement from care. Female patients, patients with baseline CD4 counts ≥200 cells/mm3, and patients with a low WHO stage category (I and II) were more likely to return to care after an experience of disengagement from HIV care (P < 0.05). Eight interviewee transcripts showed the following reported reasons for disengagement in care: long distances, stigma, work-related problems, medication side effects, competing priorities, perceived recovery of the health status, medication fatigue, and not being informed of their clinic return dates. Motivators for re-engagement in care included hospital admissions, fear of getting sick like their spouse, and phone reminders. Conclusion A vast majority of patients currently active in care experienced multiple events of disengagement from care. Thus, early identification of those who disengage from care is recommended, before they become lost to follow-up. Disclosures All authors: No reported disclosures.

Determinants of loss to follow-up among people living with HIV on antiretroviral therapy in Nigeria

2021 ◽  
Vol 20 (1) ◽  
pp. 93-99
Author(s):  
Farouq Muhammad Dayyab ◽  
Fahad Mukhtar ◽  
Garba Iliyasu ◽  
Abdulrazaq Garba Habib
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Loss To Follow Up ◽  
Living With Hiv

scholarly journals 876. Renal Function, Lipid Profile, and Cardiovascular Events After Switching to Abacavir Containing Regimen in Antiretroviral-Therapy-Experienced People Living with HIV in Northern Thailand

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S529-S530
Author(s):  
Pitchaporn Phudphong ◽  
Quanhathai Kaewpoowat ◽  
Vuddhidej Ophascharoensuk ◽  
Saowaluck Yasri
Keyword(s):  
Renal Function ◽  
Antiretroviral Therapy ◽  
Lipid Profile ◽  
Cardiovascular Events ◽  
Demographic Data ◽  
Developed Countries ◽  
People Living With Hiv ◽  
Northern Thailand ◽  
Living With Hiv

Abstract Background Abacavir (ABC) is commonly used as part of antiretroviral therapy (ART) regimen for people living with HIV (PLWH) with renal dysfunction in resource limiting countries. While the renal function changes and association with cardiovascular (CV) events have been well described in developed countries, these information is limited in Asian population. Herein, this study aims to describe the changes in renal function, lipid profile and CV events after ABC switching in ART-experienced PLWH in Northern Thailand. Methods This retrospective chart-review study was conducted among adults ART-experienced PLWH (≥18 years old) who received ABC-containing regimen during January 2016 to December 2018 at Maharaj Nakorn Chiang Mai Hospital. Demographic data, HIV-related treatments, creatinine, lipid profile and CV events were collected. Patients were categorized into early switching group and late switching group (CrCl≥50 ml/min and CrCl&lt; 50 ml/min before switching to ABC). The change of CrCl, urinalysis profiles, lipid profiles, CD4, viral load, and cardiovascular events at 12 months after ABC initiation were assessed. Results Total of 115 participants were enrolled with mean age of 55.2±10.7 years and 63.5% were male. Of those, 87.8% of patients had received Tenofovir disoproxil fumarate (TDF) prior to ABC. Mean of CrCl at baseline was 47.6±16.8 ml/min and at 12th month was 49.56±19.42 ml/min with mean difference of 3.7 ml/min (95%CI 1.6-5.8, P&lt; 0.001). The improvement of CrCl at 12 months in early switching group was statistically significant compared to late switching. Other two associated factors with improved CrCl after switching to ABC were duration of TDF exposure during CrCl&lt; 60 ml/min (OR 9.26, P 0.004) and history of protease inhibitors (PIs) exposure (OR 0.06, P 0.03). No significant changed in lipid profile, CD4 and virological outcome overtime. There were only 2 CV events observed (9.3:1000 person-year, 95%CI 2.3-37.1). Figure. (1) Creatinine clearance (ml/min) during follow up period. (2) Triglyceride (mg/dl) during follow-up period. (3) Total cholesterol (mg/dl) during follow up period. (4) LDL (mg/dl) during follow up period. (5) HDL (mg/dl) during follow up period. (6) CD4 (cells/mm3) during follow up period Conclusion ABC used in Thai ART-experienced PLWH appeared to be effective with low CV event in the first year. Despite the statistically significant in the change of CrCl after ABC switching, the change was subtle and need further evaluation. Disclosures All Authors: No reported disclosures

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2019 ◽  
Author(s):  
Gbenga Ayodele Kayode ◽  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
...  
Keyword(s):  
Hiv Treatment ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Differentiated Care

Abstract Background: An estimated 280,000 adults aged 50 years and above live with HIV in Nigeria, a population set to increase with ART efficacy and expanding coverage. To learn how elderly people living with HIV (EPLHIV) in Nigeria fare, despite not being prioritized by the national treatment program, and to deepen knowledge for their differentiated care and achieve better outcomes, the Nigerian HIV Geriatric Cohort (NHGC) was setup. Methods: Patient-level data spanning the period 2004 to 2018, obtained from comprehensive HIV treatment hospitals, that are supported by four major PEPFAR-implementing partners in Nigeria was used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined geriatric/elderly as those aged 50 years and above. From de-identified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was extracted, merged into a single REDcap® database, and described using STATA 13. Results: A total of 101,652 unique EPLHIV entries were analysed. This cohort’s data was of 53,608 (52.7%) women, 51,037 (71.4%) of EPLHIV identified as married and 33,446 (51.1%) unemployed. Mean age was 57.1 years (SD=6.9) with average duration on ART as 4.6 years (SD=3.5). ART profile showed that 88,792 (95.7%) were on 1st-line and 55,905 (64.9%) were on TDF-based regimens. Mean-body mass index (BMI) was 23.0 kg/m2 (SD=5.4 kg/m2) with 56,010(55.1%), 19,619(19.3%) and 8844 (8.7%) showing normal (18.5kg/m2–24.9kg/m2), overweight (BMI 25- <30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. Hypertensive readings (systolic-BP >140mmHg or diastolic-BP >90mmHg) was found in 21,550 (21.2%) ELHIV records. Mean CD4 count was 420cells/µL (SD=285cells/µL) and 83,660(82.3%) had a viral load result showing <1000copies/ml. As for treatment outcomes, available records showed that 54.1% were active-in-treatment, 28.4% were lost-to-follow-up and 6.8% died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths. Conclusions: The study described the clinical and non-clinical profile of EPLHIV in Nigeria. This study provides vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV. Findings from further analysis of this cohort will be applied to improve the quality of health of EPLHIV.

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