Rate of and Risk Factors for Loss to Follow Up in HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Studyopen access
- Authors
- Seong, Hye; Choi, Yunsu; Kim, Minjeong; Kim, Jung Ho; Song, Joon Young; Kim, Shin-Woo; Kim, Sang Il; Kim, Youn Jeong; Park, Dae Won; Park, Boyoung; Choi, Bo Youl; Choi, Jun-Yong
- Issue Date
- Mar-2023
- Publisher
- Korean Society of Infectious Diseases; Korean Society for Antimicrobial Therapy
- Keywords
- Antiretroviral therapy; Human immunodeficiency virus; Loss to follow up; Korea HIV; AIDS cohort; Risk factor
- Citation
- Infection and Chemotherapy, v.55, no.1, pp 69 - 79
- Pages
- 11
- Indexed
- SCOPUS
ESCI
KCI
- Journal Title
- Infection and Chemotherapy
- Volume
- 55
- Number
- 1
- Start Page
- 69
- End Page
- 79
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62989
- DOI
- 10.3947/ic.2022.0059
- ISSN
- 2093-2340
2092-6448
- Abstract
- Background
Owing to antiretroviral therapy (ART), acquired immune deficiency syndrome (AIDS)-related mortality has significantly decreased. Retaining in care is an essential step for human immunodeficiency virus (HIV) care cascade. This study investigated the incidence of and risk factors for loss to follow-up (LTFU) in Korean people living with HIV (PLWH).
Materials and Methods
Data from the Korea HIV/AIDS cohort study (including prospective interval cohort and retrospective clinical cohort) were analyzed. LTFU was defined as not visiting the clinic for more than 1 year. Risk factors for LTFU were identified using the Cox regression hazard model.
Results
The study enrolled 3,172 adult HIV patients (median age, 36 years; male 92.97%). The median CD4 T cell count at enrollment was 234 cells/mm3 (interquartile range [IQR]: 85 - 373) and the median viral load at enrollment was 56,100 copies/mL (IQR: 15,000 - 203,992). The total follow-up duration was 16,487 person-years, and the overall incidence rate of LTFU was 85/1,000 person-years. In the multivariable Cox regression model, subjects on ART were less likely to have LTFU than subjects not on ART (hazard ratio [HR] = 0.253, 95% confidence interval [CI]: 0.220 - 0.291, P <0.0001). Among PLWH on ART, female sex (HR = 0.752, 95% CI: 0.582 - 0.971, P = 0.0291) and older age (>50: HR = 0.732, 95% CI: 0.602 - 0.890; 41 - 50: HR = 0.634, 95% CI: 0.530 - 0.750; 31 - 40: HR = 0.724, 95% CI: 0.618 - 0.847; ≤30: reference, P <0.0001) were associated with high rate of retention in care. The viral load at ART initiation ≥1,000,001 (HR = 1.545, 95% CI: 1.126 - 2.121, ≤10,000: reference) was associated with a higher rate of LTFU.
Conclusion
Young and male PLWH may have a higher rate of LTFU, and an increased rate of LTFU may induce virologic failure.
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Collections - 2. Clinical Science > Department of Infectious Diseases > 1. Journal Articles
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