Infect Chemother.
2023 Mar;55(1):69-79. 10.3947/ic.2022.0059.
Rate of and Risk Factors for Loss to Follow Up in HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study
- Seong H
1,2,3 - Choi Y4,5
- Kim M6
- Kim JH1,2
- Song JY3
- Kim SW7
- Kim SI8
- Kim YJ9
- Park DW3
- Park B4
- Choi BY4,5
- Choi JY1,2
- Affiliations
-
- 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 2AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
- 3Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- 4Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- 5Institute for Health and Society, Hanyang University, Seoul, Korea
- 6Division of Data Technology, Tokyo Electron Korea Ltd, Hwaseong, Gyeonggi-do, Korea
- 7Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- 8Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 9Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- KMID: 2541533
- DOI: http://doi.org/10.3947/ic.2022.0059
Abstract
- Background
Owing to antiretroviral therapy (ART), acquired immune deficiency syndrome (AIDS)-related mortality has significantly decreased. Retaining in care is an essential step for human immunodeficiency virus (HIV) care cascade. This study investigated the incidence of and risk factors for loss to follow-up (LTFU) in Korean people living with HIV (PLWH).
Materials and Methods
Data from the Korea HIV/AIDS cohort study (including prospective interval cohort and retrospective clinical cohort) were analyzed. LTFU was defined as not visiting the clinic for more than 1 year. Risk factors for LTFU were identified using the Cox regression hazard model.
Results
The study enrolled 3,172 adult HIV patients (median age, 36 years; male 92.97%). The median CD4 T cell count at enrollment was 234 cells/mm 3 (interquartile range [IQR]: 85 - 373) and the median viral load at enrollment was 56,100 copies/mL (IQR: 15,000 - 203,992). The total follow-up duration was 16,487 person-years, and the overall incidence rate of LTFU was 85/1,000 person-years.In the multivariable Cox regression model, subjects on ART were less likely to have LTFU than subjects not on ART (hazard ratio [HR] = 0.253, 95% confidence interval [CI]: 0.220 -0.291, P<0.0001). Among PLWH on ART, female sex (HR = 0.752, 95% CI: 0.582 - 0.971, P = 0.0291) and older age (>50: HR = 0.732, 95% CI: 0.602 - 0.890; 41 - 50: HR = 0.634, 95% CI: 0.530 - 0.750; 31 - 40: HR = 0.724, 95% CI: 0.618 -0.847; ≤30: reference, P <0.0001) were associated with high rate of retention in care. The viral load at ART initiation ≥1,000,001 (HR = 1.545, 95% CI: 1.126 - 2.121, ≤10,000: reference) was associated with a higher rate of LTFU.
Conclusion
Young and male PLWH may have a higher rate of LTFU, and an increased rate of LTFU may induce virologic failure.
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