HIV: pesquisa atual
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Predictors of Loss to Follow up among HIV Infected Patients Initiated on Second Line ART in Southwestern Uganda

Nuwagira E, Rhoda Winnie M, Amir A and Muzoora C

Background: There is an increasing need for second-line therapy in resource-limited settings in sub-Saharan African countries. We sought to describe the one-year incidence of loss to follow up and mortality among patients taking second line ART at an experienced ART program in southwestern Uganda.

Methods: A retrospective cohort study was conducted at Mbarara Regional Referral Hospital mHIV clinic among adults who started second line ART between 2002 and 2017. We assessed social-demographic, clinical and laboratory variables routinely collected at the initiation of msecond line ART. Variables that had a p<0.05 in unadjusted bivariate analyses were included into a multivariate binomial regression model using a step wise backward selection procedure to describe the factors that independently predicted loss to follow up and mortality at p<0.05

Results: Records from 921 patients (56.1% females) were analysed; their mean age ± SD was 37.6 ± 9 years. More than half (52.5%) had a CD4 T cell count less than 100 cells/μl at the start of second line. The incidence of loss to follow up was 26.7 per 100 person years. Male sex (Adjusted risk ratio (ARR)=1.7, 95% CI 1.2-2.4) p=0.003, medical history of Cryptococcus meningitis (ARR=3.5, 95% CI 1.7-7.0) p<0.001 and Haemoglobin less than 10 g/dl (RR=1.3 95% C.I: 1.1-2.7 p=0.008 were strongly associated with loss to follow up.

Conclusions: There is a high incidence of loss to follow up among patients taking second line ART at a tertiary ART center in South-Western Uganda.