Incidence rate, predictors and outcomes of interruption of HIV care: nationwide results from the Belgian HIV cohort

Autor: André Sasse, S De Wit, H Van Oyen, Eric Florence, D Van Beckhoven, J Macq, Chloé Wyndham-Thomas
Přispěvatelé: UCL - SSS/IRSS - Institut de recherche santé et société
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
No-Show Patients
IMPACT
HIV Infections
Loss to follow-up
Logistic regression
Cohort Studies
0302 clinical medicine
Belgium
Risk Factors
Health care
Medicine and Health Sciences
Pharmacology (medical)
030212 general & internal medicine
Original Research
INFECTED PATIENTS
Incidence
Incidence (epidemiology)
Health Policy
ENGAGEMENT
Middle Aged
Viral Load
Infectious Diseases
Retention
Cohort
symbols
Female
HEALTH
HIV care
Viral load
Adult
retention
medicine.medical_specialty
Anti-HIV Agents
CASCADE
Maintenance
maintenance
Medication Adherence
03 medical and health sciences
symbols.namesake
VISITS
medicine
Humans
Poisson regression
re‐engagement
BARRIERS
business.industry
MORTALITY
Patient Acceptance of Health Care
Re-engagement
030112 virology
Confidence interval
CD4 Lymphocyte Count
Blood pressure
loss to follow‐up
Emergency medicine
HIV-1
FOLLOW-UP
business
Zdroj: HIV Medicine, Vol. n.a., p. 10p. (2020)
HIV MEDICINE
HIV Medicine
ISSN: 1464-2662
1468-1293
Popis: Objectives: We aimed to study the incidence rate, predictors and outcomes of HIV care interruption (HCI) in Belgium. Methods: We analysed data for adult patients with at least two HIV care records in the Belgian HIV cohort between 1 January 2007 and 31 December 2016. An HCI episode was defined as 1 year without an HIV care record. The HCI incidence rate was analysed using Poisson regression, return to HIV care using a cumulative incidence function with death as a competing risk, and viral load (VL) status upon return to HIV care using logistic regression. Results: We included 16 066 patients accounting for 78 625 person-years of follow-up. The incidence rate of HCI was 5.3/100 person-years [95% confidence interval (CI) 5.1–5.4/100 person-years]. The incidence of return to HIV care after HCI was estimated at 77.5% (95% CI 75.7–79.2%). Of those who returned to care, 43.7% had a VL ≤ 200 HIV-1 RNA copies/mL, suggesting care abroad or suboptimal care (without an HIV-related care record) in Belgium during the HCI, and 56.3% returned without controlled VL and were therefore considered as having experienced a real gap in HIV care; they represented 2.3/100 person-years of follow-up. Factors individually associated with HCI were no antiretroviral therapy (ART) uptake, lower age, injecting drug use, non-Belgian nationality, male gender, not being a man who has sex with men, a shorter time since HIV diagnosis, no high blood pressure and CD4 count < 350 cells/µL. Conclusions: This study highlights the need to investigate return to care and viral status at return, to better understand HCI. Identified predictors can help health care workers to target patients at higher risk of HCI for awareness and support. © 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association
Databáze: OpenAIRE
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