Loss to followup of HIVinfected patients on antiretroviral treatment programmes Franois Dabis

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Loss to follow-up of HIV-infected patients on
antiretroviral treatment programmesFrançois
Dabis Eric Balestre
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Early loss of HIV-infected patients on potent
antiretroviral therapy programmesin lower-income
countriesThe ART-LINC Collaboration of
IeDEABrinkhof M, Dabis F, Myer L, Anglaret
X.Bull WHO ahead of print (July 2008)
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Early loss of HIV-infected patients on potent
antiretroviral therapy programmesin lower-income
countriesN 5 491 Early patient losses were
increasingly common when programmes were scaled
up and were associated with a fee for service and
advanced immunodeficiency at baseline. Measures
to maximize ART programme retention are required
in resource-poor countries 
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Study population and inclusion criteria

• ART-LINC of IeDEA 2nd merger 20 cohorts, n45
  765
• Year of birth documented, age 16 years at ART
  initiation n44 270
• Gender documented n44 223
• ART starting date documented n43 218
• ART naive patients n38 686
• At least 1 day of follow-up after ART initiation
  N36 729
• (N 5 491 in the first merger / Bull WHO)

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Characteristics of the ART programmes (1)
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Characteristics of the ART programmes (2)
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Characteristics of the patientsincluded in the
data analysis of second merger (1)
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Characteristics of the patientsincluded in the
data analysis of second merger (2)
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Lost to follow-up definition

• We categorized a patient as lost to follow-up if
• He/she was not known to have died,
• The last follow-up visit occured within 6, 12 or
  24 months after ART initiation,
• The database remained open for an additional 6
  months or more (or 3 months in sensitivity
  analysis).

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Number and of patients lost to follow-up (1)
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Number and of patients lost to follow-up (2)
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Individual patient factors associated with LTFU
in the first 6 months after starting ART
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Individual patient factors associated with loss
to follow-up in the first 12 months after
starting ART
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Individual patient factors associated with loss
to follow-up in the first 24 months after
starting ART
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The clinical and economic impact of interventions
to prevent loss to follow-up in resource-limited
settings

• Elena Losina, Hapsatou Touré, Lauren Uhler, Eric
  Balestre, Eugène Messou, Milton C. Weinstein,
  Xavier Anglaret,
• François Dabis, Kenneth A. Freedberg.
• 12th International workshop on HIV observational
  databases
• March 28, 2008
• Malaga, Spain