scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018. 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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified 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. prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%) EPLHIV 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: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018.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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified 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. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%). EPLHIV 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: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018.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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified 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. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%). EPLHIV 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, 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: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
One Year ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018. 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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was examined. Results: A total of 101,652 EPLHIV were analysed. Women accounted for 53,608(53%), 51,037(71%) of EPLHIV identified as married and 33,446(51%) unemployed. Median age was 57.1years (IQR 52–60 years) with a median duration on ART treatment of 4.1years (IQR 1.7–7.1years). ART profile showed that 97,586(96%) were on 1st-line and 66,125(65%) were on TDF-based regimens. Median body mass index (BMI) was 22.2 kg/m 2 (IQR 19.5–25.4kg/m 2 ) with 43,012(55%), 15,081(19%) and 6,803(9%) showing normal (18.5–<25kg/m 2 ), overweight (BMI 25–<30kg/m 2 ) and obese (BMI ≥30kg/m 2 ) ranges respectively. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 16,201(21%). EPLHIV Median CD4 count was 381cells/μL (IQR 212-577cells/μL) and 26,687(82%) had a viral load result showing <1000copies/ml within one year of their last visit. As for outcomes at their last visit, 62,821(62%) were on active-in-treatment, 28,463(28%) were lost-to-follow-up and 6,912(7%) died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths. Conclusions: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort profile: the Nigerian HIV geriatric cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
One Year ◽  
Lost To Follow Up

Abstract Background The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018. 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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified 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 EPLHIV were analysed. Women accounted for 53,608 (53%), 51,037 (71%) of EPLHIV identified as married and 33,446 (51%) unemployed. Median age was 57.1 years (IQR 52–60 years) with a median duration on ART treatment of 4.1 years (IQR 1.7–7.1 years). ART profile showed that 97,586 (96%) were on 1st-line and 66,125 (65%) were on TDF-based regimens. Median body mass index (BMI) was 22.2 kg/m2 (IQR 19.5–25.4 kg/m2) with 43,012 (55%), 15,081 (19%) and 6803 (9%) showing normal (BMI 18.5 – < 25 kg/m2), overweight (BMI 25 - < 30 kg/m2) and obese (BMI ≥30 kg/m2) ranges respectively. Prevalence of hypertension (systolic-BP > 140 mmHg or diastolic-BP > 90 mmHg) was 16,201 (21%). EPLHIV median CD4 count was 381 cells/μL (IQR 212–577 cells/μL) and 26,687 (82%) had a viral load result showing < 1000copies/ml within one year of their last visit. As for outcomes at their last visit, 62,821 (62%) were on active-in-treatment, 28,463 (28%) were lost-to-follow-up, 6912 (7%) died and 2456 (3%) had stopped or transferred out. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths. Conclusions This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
One Year ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup 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. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018.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 were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified 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 EPLHIV were analysed. Women accounted for 53,608 (53%) women, 51,037 (71%) of EPLHIV identified as married and 33,446 (51%) unemployed. Median age was 57.1 years (IQR 52 – 60 years) with a median duration on ART treatment of 4.1 years (IQR 1.7 – 7.1 years). ART profile showed that 97,586 (96%) were on 1st-line and 66,125 (65%) were on TDF-based regimens. Median body mass index (BMI) was 22.2 kg/m2 (IQR 19.5 – 25.4kg/m2) with 43,012 (55%), 15,081 (19%) and 6,803 (9%) showing normal (18.5 – <25kg/m2), overweight (BMI 25 - <30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 16,201 (21%). EPLHIV Median CD4 count was 381 cells/μL (IQR 212 - 577 cells/μL) and 26,687 (82%) had a viral load result showing <1000copies/ml within one year of their last visit. As for outcomes at their last visit, 62,821 (62%) were on active-in-treatment, 28,463 (28%) were lost-to-follow-up and 6,912 (7%) died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths.Conclusions: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

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.

scholarly journals The Problem of Relationships between Doctor and HIV-Infected Patient

2016 ◽  
Vol 5 (2) ◽  
pp. 23-32
Author(s):  
A. Makhamatova
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Social Factor ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Services Utilization ◽  
Highly Active ◽  
Health Practitioners ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Methodological Difficulties

This paper presents the foreign literature review on the relationships between doctor and patient as a psycho-social factor affecting the various HIV treatment and care outcomes. While some researchers have found an association between the "patient-provider" relationships and missed clinic visits, following the medical advice (adherence to highly active antiretroviral therapy), some diagnostic services’ utilization and the length of hospitalizations, the other researchers did not find such evidences. In general, "patient-provider" relationships research involves methodological difficulties, such as the accuracy and validity of the scales used; it indicates the need for further theoretical and empirical research in this field. The article may be of interest to researchers in the fields of sociology and social psychology of health, practitioners and also specialists developing prevention programs for people living with HIV.

scholarly journals Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

2020 ◽  
Author(s):  
Melissa A. Stockton ◽  
Bradley N. Gaynes ◽  
Mina C. Hosseinipour ◽  
Audrey E. Pettifor ◽  
Joanna Maselko ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Load Testing ◽  
Art Initiation ◽  
Retention In Hiv Care ◽  
Hiv Care Engagement ◽  
Care Outcomes ◽  
Sub Saharan ◽  
Living With Hiv

Abstract As in other sub-Saharan countries, the burden of depression is high among people living with HIV in Malawi. However, the association between depression at ART initiation and two critical outcomes—retention in HIV care and viral suppression—is not well understood. Prior to the launch of an integrated depression treatment program, adult patients were screened for depression at ART initiation at two clinics in Lilongwe, Malawi. We compared retention in HIV care and viral suppression at 6 months between patients with and without depression at ART initiation using tabular comparison and regression models. The prevalence of depression among this population of adults newly initiating ART was 27%. Those with depression had similar HIV care outcomes at 6 months to those without depression. Retention metrics were generally poor for those with and without depression. However, among those completing viral load testing, nearly all achieved viral suppression. Depression at ART initiation was not associated with either retention or viral suppression. Further investigation of the relationship between depression and HIV is needed to understand the ways depression impacts the different aspects of HIV care engagement.

scholarly journals Antiretroviral therapy among patients with HIV in Almaty, Kazakhstan: the implication for HIV-associated tuberculosis control

2020 ◽  
Vol 14 (11.1) ◽  
pp. 128S-132S
Author(s):  
Alfiya Denebayeva ◽  
Arpine Abrahamyan ◽  
Aelita Sargsyan ◽  
Karine Kentenyants ◽  
Ainur Zhandybayeva ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Guideline ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Preventive Strategy ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Living With Hiv ◽  
And Control ◽  
The Impact

Introduction: Antiretroviral therapy (ART) is an effective preventive strategy against tuberculosis (TB) in people living with HIV (PLWH). In Kazakhstan, according to the revised HIV treatment guideline (2017), ART should be initiated immediately after HIV diagnosis established, regardless of CD4+ count. Aim: To evaluate the impact of early initiation of ART on TB infection in PLWH registered in the Center of Prevention and Control of AIDS, Almaty, Kazakhstan, between 2008 and 2018. Methodology: A retrospective cohort study was conducted using the data of 4,053 patients from electronic HIV case management system (2008-2018) (EHCMS). Results: The study revealed low rates (12.6%) of rapid ART (≤ 1 month after HIV diagnosis). Patients in the rapid ART initiation group were less likely to develop TB compared with those who started treatment >1 month after the HIV detection (odds ratio 1.6; 95% confidence interval [1.1, 2.2]; p = 0.00799). Interestingly, the risk for developing TB among patients receiving ART ≥ 1 month after HIV diagnosis was significantly higher compared with those not taking any treatment. The latter was explained by several confounding not addressed during the analysis, since ART was prescribed to patients with primarily deeper immunodeficiency, while the patients not receiving ART were less immunocompromised. Conclusion: Despite the recently changed HIV treatment guideline in Kazakhstan, ART is still initiated based on the disease severity. In 2018, the initiation of ART during the first month after HIV diagnosis increased by 50%. However, it is necessary to reduce the time to initiation of ART for all patients.

scholarly journals Tracing people living with HIV who are lost to follow-up at ART programs in Southern Africa: a multicenter study

2020 ◽  
Author(s):  
Benedikt Christ ◽  
Marie Ballif ◽  
Nanina Anderegg ◽  
Frédérique Chammartin ◽  
Josephine Muhairwe ◽  
...  
Keyword(s):  
Southern Africa ◽  
Home Visits ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Art Programs ◽  
Record Keeping ◽  
Phone Calls ◽  
Living With Hiv ◽  
Lost To Follow Up

Introduction: Retention in care is a key element to the HIV treatment cascade and an indicator of the success of ART programs. We traced people living with HIV (PLWH) categorized as lost to follow-up (LTFU) to ascertain whether their vital or care status changed since their last visit. Methods: We used a standardized protocol to trace a stratified sample of PLWH who were LTFU at eight ART programs in South Africa, Zambia, Malawi, Zimbabwe, Lesotho and Mozambique in 2017-2019. Participants were stratified by age, gender, and time on ART. We assessed tracing process outcomes, vital status and care status of participants. Participating ART programs were members of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Southern Africa. Results: We selected a stratified random sample of 3,256 PLWH classified as LTFU; 56% were female, median age was 32 years and 53% were on ART for less than a year. Overall, no tracing was necessary for 12% of the participants, since their vital and care status could be clarified by checking existing participant files before tracing was initiated. Tracing was impossible for another 17%, for whom contact details were unavailable or incomplete. Among the 2,294 PLWH classified as LTFU who were traced by phone calls and/or home visits, 34% were alive and in care, 19% were alive but not in care, and 4% were alive but had unknown care status, while 11% had died, and 32% could not be found. Home visits were more successful than phone calls to ascertain the vital outcome of lost PLWH (OR: 2.7, 95% CI: 1.6–4.4).Conclusions: We showed that tracing allowed ascertaining the vital and care outcomes of PLWH classified as LTFU, but was challenged by insufficient record-keeping. Misclassification of outcomes and incomplete contact information are threatening the efficiency of tracing and ultimately the accuracy of program-level indicators, such as mortality and retention estimates. Our study highlights the need for centralized and standardized patient management systems at HIV clinics in low- and middle-income countries.

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