Predictors of Loss to Follow-Up among HIV-Infected Adults after Initiation of the First-Line Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia: A 5-Year Retrospective Cohort Study

• Published in: BioMed research international 2021, Vol.2021 (1), p.8659372-8659372
• Main Authors: Gebremichael, Mathewos Alemu, Gurara, Mekdes Kondale, Weldehawaryat, Haymanot Nigussie, Mengesha, Melkamu Merid, Berbada, Dessalegn Ajema
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Activities of daily living; Adolescent; Adult; Adults; AIDS; Analysis; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Body weight; Care and treatment; Cohort analysis; Cohort Studies; Data management; Dosage and administration; Drug dosages; Drug resistance; Drug therapy; Drug use; Ethiopia - epidemiology; Female; Follow-Up Studies; Health aspects; Health hazards; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - mortality; HIV patients; Hospitals, General; Human immunodeficiency virus; Humans; Immunology; Incidence; Infections; Kaplan-Meier Estimate; Lost to Follow-Up; Male; Medical personnel; Middle Aged; Mortality; Patient compliance; Patients; Proportional Hazards Models; Public health; Random sampling; Rank tests; Retrospective Studies; Rural areas; Sample size; Sampling techniques; Sociodemographics; Statistical analysis; Statistical models; Statistical sampling; Survival; Therapy; Young Adult
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2021/8659372

Background. Loss to follow-up (LTFU) from antiretroviral therapy (ART) reduces treatment benefits and leads to treatment failure. Hence, this study was aimed at determining the incidence of loss to follow-up and predictors among HIV-infected adults who began first-line antiretroviral therapy at Arba Minch General Hospital. Methods. We carried out an institutional-based retrospective cohort study, and data were collected from the charts of 508 patients who were selected using a simple random sampling technique. All the data management and statistical analyses were conducted using STATA version 14. Cumulative survival probability was estimated and presented in the life table, and the Kaplan-Meir survival curves were compared using the log-rank test. The Cox proportional hazard model was used to identify the independent predictors. Results. We followed 508 patients for 871.9 person-years. A total of 46 (9.1%) experienced loss to follow-up, yielding an overall incidence rate of 5.3 (95% CI: 3.9-7.1) per 100 person-years. The cumulative survival probability was 90%, 88%, 86%, and 86% at the end of one, two, three, and four years, respectively. The predictors identified were age less than 35 years (adjusted hazard ratio (aHR=1.96; 95% CI: 1.92-4.00)), rural residence (aHR=1.98; 95% CI: 1.02-3.83), baseline body weight greater than 60 kilograms (aHR=2.19; 95% CI: 1.11-4.37), a fair level of adherence (aHR=11.5; 95% CI: 2.10-61.10), and a poor level of adherence (aHR=12.03; 95% CI: 5.4-26.7). Conclusions. In this study, the incidence rate of loss to follow-up was low. Younger adults below the age of 35 years, living in rural areas, with a baseline weight greater than 60 kilograms, which had a fair and poor adherence level were more likely to be lost from treatment. Therefore, health professionals working in ART clinics and potential stakeholders in HIV/AIDS care and treatment should consider adult patients with these characteristics to prevent LTFU.