The Majority of the Pre-Antiretroviral Population Who Were Lost to Follow-Up Stopped Their Care in Freetown, Sierra Leone: A 12-Month Prospective Cohort Study Starting with HIV Diagnosis

PloS One
J Daniel KellyThomas P Giordano

Abstract

The heterogeneity of the pre-antiretroviral (pre-ART) population calls for more granular depictions of the cascade of HIV care. We studied a prospective cohort of persons newly diagnosed with HIV infection from a single center in Freetown, Sierra Leone, over a 12-month period and then traced those persons who were lost to follow-up (LTFU) during pre-ART care (before ART initiation). ART eligibility was based on a CD4 cell count result of ≤ 350 mm/cells and/or WHO clinical stage 3 or 4. Persons who attended an appointment in the final three months were considered to be retained in care. Adherence to ART was measured using pharmacy refill dates. "Effective HIV care" was defined as completion of the cascade of care at 12-months regardless of whether patients are on ART. Tracing outcomes were obtained for those who were LTFU during pre-ART care. 408 persons newly diagnosed with HIV infection were screened, 338 were enrolled, and 255 persons were staged for ART. ART-ineligible persons had higher retention rates than ART-eligible persons (59.6% vs 41.8%, p = 0.03). 77 (22.8%) of 338 persons received effective HIV care. Most attrition (61.9%) occurred with persons during pre-ART care. 123 of 138 persons (89.1%) who were LTFU prior to ...Continue Reading

References

Dec 14, 2005·Current HIV/AIDS Reports·Thomas P GiordanoRichard M Grimes
Mar 28, 2008·Current HIV/AIDS Reports·Robert Grossberg, Robert Gross
Sep 12, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Elvin H GengJeffrey N Martin
Nov 13, 2010·PloS One·Katharina KranzerRobin Wood
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Jun 29, 2015·Lancet·Peter PiotUNKNOWN UNAIDS–Lancet Commission

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Citations

Sep 28, 2018·SAHARA J : Journal of Social Aspects of HIV/AIDS Research Alliance·J Daniel KellyM Bailor Barrie
Jul 23, 2021·Journal of the International AIDS Society·Catrina MugglinUNKNOWN International epidemiology Databases to Evaluate AIDS in Southern Africa

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