High Treatment Retention Rate in HIV-Infected Patients Receiving Antiretroviral Therapy at Two Large HIV Clinics in Hanoi, Vietnam

Loss to follow-up (LTFU) is viewed as a major challenge in improving retention in HIV treatment. In Vietnam, the reasons for disengagement from clinics and the effect of injection drug use (IDU) on LTFU with unknown outcome (true LTFU) are not well known.

Patients receiving antiretroviral therapy (ART) from two HIV clinics in Hanoi were included in this observational study between 2007 and 2012, and followed up every 6 months until the end of 2013. The reasons for disengagement from the clinic, and ART status during imprisonment were investigated in patients with a history of IDU to identify true LTFU. The retention rate at 6–54 months and true LTFU rate were calculated. Cox proportional hazards regression models were performed to identify factors associated with true LTFU.

There were 1,431 patients, with a follow-up time of 4,371 person-years (median 2.49 years). At the end of the follow-up period, 71 (5.0%) patients died, 79 (5.5%) transferred to other clinics, 16 (1.1%) disengaged from the clinics, and the calculated true LTFU was 45 (3.1%), with 12-month ART retention rate of 95.3% for the entire study population. Imprisonment was the most frequent reason for disengagement from the clinics. True LTFU correlated significantly with low CD4 count and high plasma viral load, but not history of IDU.

Imprisonment is a major cause of disengagement from HIV care among patients with a history of IDU.

Below:  Retention rate for ART at 6–54 months after study enrollment.

The retention rate was calculated by dividing the number of patients who were still alive and on ART at 6–54 months by the total number of patients who had been followed up for 6–54 months, including those who died, those lost to follow-up, and those who disengaged from the clinic. Patients who were transferred to other clinics were excluded. Months; months after enrollment, n: number of the subjects for analysis,—;95%CI.

Full article at: http://goo.gl/QmM1sK

By:

Shoko Matsumoto, Junko Tanuma, Daisuke Mizushima, Shinichi Oka

AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan

Shoko Matsumoto

Graduate School of Public Health, Teikyo University, Tokyo, Japan

Daisuke Mizushima

Center for AIDS Research, Kumamoto University, Kumamoto, Japan

Ngoc Chi Thi Nguyen, Thanh Thuy Thi Pham, Cuong Duy Do, Tuan Quang Nguyen

Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam

Dung Thi Nguyen, Hoai Dung Thi Nguyen, Lam Tien Nguyen, Kinh Van Nguyen

National Hospital of Tropical Diseases, Hanoi, Vietnam

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