Characteristics and Outcomes of Adult Patients Lost to Follow-Up at an Antiretroviral Treatment Clinic in Johannesburg, South Africa

• DOI: 10.1097/qai.0b013e31815b833a
• Publication Date: 2009-03-05T03:35:43Z
• Authors: Rishikesh P Dalal; Catherine MacPhail; Mmabatho Mqhayi; Jeff Wing; Charles Feldman; Matthew F Chersich; Willem D F Venter
• Keywords: Lost to follow-up

Background: A significant proportion of those initiating antiretroviral treatment (ART) for HIV infection are lost to follow-up. Causes discontinuing ART follow-up in resource-limited settings not well understood. Methods: retrospective analysis was conducted all adult patients receiving at an urban public clinic Johannesburg, South Africa between April 2004 and June 2005. Patients least 6 weeks were identified further studied, causes default tabulated. Results: Of 1631 267 (16.4%) discontinued during the study period. Gender, ethnicity, age predictive loss follow-up, 173 (64.8%) successfully traced. Death accounted 48% (n = 83) Characteristics associated with death older initiation (P 0.022), lower baseline CD4 cell count 0.0073), higher initial RNA load 0.024), weight on 0.033). Date known 71% 59) traced deceased, whom 83% 49) had died within 30 days active ART. Common nonmortality losses included relocation or transfer (25.4%) hospitalization illness resulting (10.4%). Few cited financial difficulty medication toxicity as reasons Conclusions: Nearly 1 a resource-constrained setting over 15-month Early mortality high, especially profound immunosuppression. Improving access care streamlining patient tracking may improve outcomes.