Functional Status and Incidence of Loss to Follow-up after Antiretroviral Therapy Initiation
Abstract
Taking medication for lifetime puts Human Immunodeficiency Virus (HIV)-infected patients in challenging situations. The loss to follow-up (LTFU) is a major problem arising from their non-compliance. Information about functional status as a predictor of LTFU is limited. Therefore, this study was aimed to identify the association between the functional status and the incidence of LTFU among HIV patients at Saiful Anwar General Hospital, Indonesia. A retrospective cohort study was conducted in the tropical diseases and infections division of the Saiful Anwar General Hospital by observing 148 HIV patients who were diagnosed in 2015. Data were collected based on existing data in medical records. The log-rank test was used to compare the time of LTFU between groups. Cox proportional hazard was used to determine the effect of functional status after being controlled by other variables. This study found that 65.9% of HIV patients were able to retain on antiretroviral therapy for 39 months. Functional status had a significant association with the time LTFU occurred. Ambulatory patients had a higher risk of experiencing LTFU than working functional status (AHR = 2.289; 95% CI 1.106–4.738; p-value = 0.026). Identifying the patient’s characteristic that has a higher risk of LTFU helps to determine the right strategy to ensure treatment adherence.
Keywords: antiretroviral therapy (ART), functional status, HIV, loss to follow-up (LTFU), Indonesia
References
[1] UNAIDS. (2020). Global HIV & AIDS Statistics - 2020 Fact Sheet. Retrieved from https://www.unaids. org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf.
[2] UNAIDS. (2014). An Ambitious Treatment Target to Help End the AIDS Epidemic. Retrieved from https: //www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf.
[3] UNAIDS. (2020). Indonesia HIV Statistics. Retrieved from https://www.unaids.org/en/regionscountries/ countries/indonesia.
[4] Kementerian Kesehatan Republik Indonesia. (2018). Laporan Perkembangan HIV AIDS dan Infeksi Menular Seksual Triwulan IV tahun 2017. Retrieved from https://www.kemkes.go.id/resources/ download/pusdatin/infodatin/InfoDatin-HIV-AIDS-01.pdf.
[5] Gezae, K. E., Abebe, H. T. and Gebretsadik, L. G. (2019). Incidence And Predictors Of LTFU Among Adults With TB / HIV Co-Infection In Two Governmental Hospitals, Mekelle, Ethiopia, 2009 – 2016: Survival Model Approach. BioMed Central Infectious Disease, vol. 19, issue 107, pp. 1-9.
[6] Zürcher, K., et al. (2017). Outcomes Of HIV-Positive Patients Lost To Follow-Up In African Treatment Programmes. Tropical Medicine and International Health, vol. 22, issue 4, pp. 375-87.
[7] Rachlis, B., et al. (2015). Evaluating Outcomes of Patients Lost to Follow-Up in A Large Comprehensive Care Treatment Program in Western Kenya. Journal of Acquired Immune Deficiency Syndromes, vol. 68, issue 4, pp. 46-55.
[8] Assemie, M. A., Muchie, K. F. and Ayele, T. A. (2018). Incidence and Predictors of Loss to Follow up Among HIV Infected Adults at Pawi General Hospital, Northwest Ethiopia: Competing Risk Regression Model. BioMed Center Ressearch Notes, vol. 11, issue 287, pp. 1-6.
[9] World Health Organization. (2016). Global Report on Early Warning Indicators of HIV Drug Resistance: Technical Report. Retrieved from https://www.who.int/hiv/pub/drugresistance/ewi-hivdr-2016/en/.
[10] Zhou, J., et al. (2012) Loss to Follow up in HIV-Infected Patients from Asia-Pacific Region: Results from TAHOD. AIDS Research and Treatment, vol. 2012, issue 375217, pp. 1-10.
[11] Mekonnen, N., et al. (2019). Incidence and Predictors of Loss to Follow ‑ Up Among HIV Infected Adults after Initiation of First Line Anti ‑ Retroviral Therapy at University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia, 2018: Retrospective Follow Up Study. BioMed Center Research Notes, vol. 12, issue 1, pp. 1-7.
[12] Berheto, T. M., Haile, D. B. and Mohammed, S. (2014). Predictors of Loss to Follow-Up in Patients Living with HIV/AIDS after Initiation of Antiretroviral Therapy. North American Journal of Medical Sciences, vol. 6, issue 9, pp. 453-59.
[13] Birhanu, A., et al. (2020). Incidence and Predictors of Loss to Follow up Among Adult HIV Patients on Antiretroviral Therapy in University of Gondar Comprehensive Specialized Hospital: A Competing Risk Regression Modeling. PLOS One, vol. 15, issue 1, pp. 1-14.
[14] Balogun, M., et al. (2019). Status Of HIV-Infected Patients Classified as Lost to Follow Up from a Large Antiretroviral Program in Southwest Nigeria. PLOS One, vol. 14, issue 7, pp. 1-15.
[15] Megerso, A., et al. (2016) Predictors of Loss to Follow-Up in Antiretroviral Treatment for Adult Patients in the Oromia Region. HIV/AIDS-Research Palliat Care, issue 8, pp. 83-92.
[16] Ayele, W., et al. (2015). Treatment Outcomes and their Determinants in HIV Patients on Anti-Retroviral Treatment Program in Selected Health Facilities of Kembata and Hadiya Zones, Southern Nations, Nationalities and Peoples Region. Ethiopia. BioMed Center Public Health, vol. 15, issue 826, pp. 1-13.
[17] Tiruneh, Y. M., et al. (2016). Retention in Care among HIV-Infected Adults in Ethiopia, 2005 – 2011: A Mixed-Methods Study. PLOS One, vol. 11, issue 6, pp. 1-17.
[18] Kementerian Kesehatan RI. (2019). Sekretariat Jenderal. Profil Kesehatan Indonesia Tahun 2019. Jakarta: Kementerian Kesehatan RI.
[19] Kementerian Kesehatan Republik Indonesia. (2015). Petunjuk Teknis Pengisian Format Pencatatan Dan Pelaporan Pasien HIV/AIDS. Jakarta: Kementerian Kesehatan Republik Indonesia.
[20] Assefa, T. and Wencheko, E. (2012). Survival Analysis of Patients Under Chronic HIV-Care and Antiretroviral Treatment at Tikur Anbessa Specialized. Ethiopian Journal of Health Development., vol. 26, issue 1, pp. 22-9.