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

Author:

Gebremichael Mathewos Alemu1ORCID,Gurara Mekdes Kondale1,Weldehawaryat Haymanot Nigussie1,Mengesha Melkamu Merid1ORCID,Berbada Dessalegn Ajema1

Affiliation:

1. School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O. Box: 021, Arba Minch, Ethiopia

Abstract

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.

Funder

Arba Minch University, College of Medicine and Health Sciences

Publisher

Hindawi Limited

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine

Reference52 articles.

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2. The Ethiopian public health institute;EPHI,2020

3. Ethiopia population-based HIV impact assessment EPHIA 2017–2018, summary sheet: preliminary findings Ethiopia;EPHIA

4. Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy

5. HIV/AIDS Fact Sheets;WHO

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