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AIDS Res Treat. 2012; 2012: 375217.
Published online Feb 22, 2012. doi:  10.1155/2012/375217
PMCID: PMC3296146
Loss to Followup in HIV-Infected Patients from Asia-Pacific Region: Results from TAHOD
Jialun Zhou, 1 Junko Tanuma, 2 Romanee Chaiwarith, 3 Christopher K. C. Lee, 4 Matthew G. Law, 1 * Nagalingeswaran Kumarasamy, 5 Praphan Phanuphak, 6 Yi-Ming A. Chen, 7 Sasisopin Kiertiburanakul, 8 Fujie Zhang, 9 Saphonn Vonthanak, 10 Rossana Ditangco, 11 Sanjay Pujari, 12 Jun Yong Choi, 13 Tuti Parwati Merati, 14 Evy Yunihastuti, 15 Patrick C. K. Li, 16 Adeeba Kamarulzaman, 17 Van Kinh Nguyen, 18 Thi Thanh Thuy Pham, 19 and Poh Lian Lim 20
1The Kirby Institute, The University of New South Wales, Sydney, NSW 2034, Australia
2National Center for Global Health and Medicine, Tokyo 162-8655, Japan
3Research Institute for Health Sciences, Chiang Mai 50200, Thailand
4Department of Medicine, Hospital Sungai Buloh, 47000 Kuala Lumpur, Malaysia
5YRG Centre for AIDS Research and Education, Chennai 600113, India
6HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
7Taipei Veterans General Hospital and AIDS Prevention and Research Centre, National Yang-Ming University, Taipei 112, Taiwan
8Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok 10400, Thailand
9Beijing Ditan Hospital, Capital Medical University, Beijing 100050, China
10National Center for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia
11Research Institute for Tropical Medicine, 1781 Manila, Philippines
12Institute of Infectious Diseases, Pune 411037, India
13Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea
14Faculty of Medicine, Udayana University and Sanglah Hospital, Bali 80233, Indonesia
15Working Group on AIDS, Faculty of Medicine, University of Indonesia/Ciptomangunkusumo Hospital, Jakarta 10430, Indonesia
16Department of Medicine, Queen Elizabeth Hospital, Hong Kong
17Faculty of Medicine, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia
18National Hospital for Tropical Diseases, Hanoi, Vietnam
19Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
20Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433
*Matthew G. Law: mlaw/at/kirby.unsw.edu.au
Academic Editor: Anthony Harries
Received October 26, 2011; Accepted December 14, 2011.
Abstract
This study examined characteristics of HIV-infected patients in the TREAT Asia HIV Observational Database who were lost to follow-up (LTFU) from treatment and care. Time from last clinic visit to 31 March 2009 was analysed to determine the interval that best classified LTFU. Patients defined as LTFU were then categorised into permanently LTFU (never returned) and temporary LTFU (re-entered later), and these groups compared. A total of 3626 patients were included (71% male). No clinic visits for 180 days was the best-performing LTFU definition (sensitivity 90.6%, specificity 92.3%). During 7697 person-years of follow-up, 1648 episodes of LFTU were recorded (21.4 per 100-person-years). Patients LFTU were younger (P = 0.002), had HIV viral load ≥500 copies/mL or missing (P = 0.021), had shorter history of HIV infection (P = 0.048), and received no, single- or double-antiretroviral therapy, or a triple-drug regimen containing a protease inhibitor (P < 0.001). 48% of patients LTFU never returned. These patients were more likely to have low or missing haemoglobin (P < 0.001), missing recent HIV viral load (P < 0.001), negative hepatitis C test (P = 0.025), and previous temporary LTFU episodes (P < 0.001). Our analyses suggest that patients not seen at a clinic for 180 days are at high risk of permanent LTFU, and should be aggressively traced.
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