Long‐term loss to follow‐up in the TREAT TREAT Asia HIV HIV Observational Database ( TAHOD TAHOD )

摘要

Objectives With earlier antiretroviral therapy ( ART ) initiation, time spent in HIV care is expected to increase. We aimed to investigate loss to follow‐up ( LTFU ) in Asian patients who remained in care 5 years after ART initiation. Methods Long‐term LTFU was defined as LTFU occurring after 5 years on ART . LTFU was defined as (1) patients not seen in the previous 12 months; and (2) patients not seen in the previous 6 months. Factors associated with LTFU were analysed using competing risk regression. Results Under the 12‐month definition, the LTFU rate was 2.0 per 100 person‐years ( PY ) [95% confidence interval ( CI) 1.8–2.2 among 4889 patients included in the study. LTFU was associated with age 50 years [sub‐hazard ratio ( SHR ) 1.64; 95% CI 1.17–2.31] compared with 31–40 years, viral load ≥ 1000 copies/ mL ( SHR 1.86; 95% CI 1.16–2.97) compared with viral load 1000 copies/ mL , and hepatitis C coinfection ( SHR 1.48; 95% CI 1.06–2.05). LTFU was less likely to occur in females, in individuals with higher CD 4 counts, in those with self‐reported adherence ≥ 95%, and in those living in high‐income countries. The 6‐month LTFU definition produced an incidence rate of 3.2 per 100 PY (95% CI 2.9–3.4 and had similar associations but with greater risks of LTFU for ART initiation in later years (2006–2009: SHR 2.38; 95% CI 1.93–2.94; and 2010–2011: SHR 4.26; 95% CI 3.17–5.73) compared with 2003–2005. Conclusions The long‐term LTFU rate in our cohort was low, with older age being associated with LTFU . The increased risk of LTFU with later years of ART initiation in the 6‐month analysis, but not the 12‐month analysis, implies that there was a possible move towards longer HIV clinic scheduling in Asia.