Revista de SIDA e investigación clínica

Predictors of Loss to Follow Up of Patients Enrolled on Antiretroviral Therapy: A Retrospective Cohort Study

Abstract

Kidane Tadesse and Fisaha Haile

Abstract Introduction: There is a growing concern about the increasing rates of Loss to Follow up (LTFU) among people who are on HIV/AIDS treatment programs. It is more common in resource-poor settings. However little is known about the time to LTFU and predictors after Antiretroviral Therapy (ART) initiation in low resource settings including Ethiopia. Method: Retrospective cohort study was employed among a total of 520 records of patients who were enrolled on antiretroviral therapy in Aksum St. Marry hospital. Baseline patient records were extracted from electronic and paper based medical records database and analysed using Kaplan Meier survival and Cox proportional hazard model to identify the independent predictors of loss to follow up of patients on ART. Result: of 520 patients, 51(9.8%) were loss giving a LTFU rate of 8.2 per 100 person- years. From these LTFU, 21(41%) occurred within the first Six months of ART initiation. The independent predictors of LTFU of patient were being smear positive pulmonary TB [Adj.HR (95% CI)=(2.05 (1.02, 4.12)], male gender [Adj. HR (95%CI)=(2.73 (1.31, 5.66)], regiment AZT-3TC-NVP [Adj. HR (95%CI)=(3.47 (1.02,11.83)] and weight ≥60kg [Adj. HR (95% CI)=(3.47 (1.02,11.83)]. Conclusion: Substantial magnitude of loss to follow up has been found among patients on ART which significantly affect the overall outcome of HIV/AIDS program of treatment. The independent predictors identified were TB smear positive, male gender, regiment AZT-3TC-NVP and lower weight. So, continuous and comprehensive follow up is necessary to minimize loss to follow up and optimize treatment outcome of people on ART.