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High Treatment Retention Rate in HIV-Infected Patients Receiving Antiretroviral Therapy at Two Large HIV Clinics in Hanoi,Vietnam
Authors:Shoko Matsumoto  Junko Tanuma  Daisuke Mizushima  Ngoc Chi Thi Nguyen  Thanh Thuy Thi Pham  Cuong Duy Do  Tuan Quang Nguyen  Dung Thi Nguyen  Hoai Dung Thi Nguyen  Lam Tien Nguyen  Kinh Van Nguyen  Shinichi Oka
Institution:1. AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.; 2. Graduate School of Public Health, Teikyo University, Tokyo, Japan.; 3. Center for AIDS Research, Kumamoto University, Kumamoto, Japan.; 4. Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam.; 5. National Hospital of Tropical Diseases, Hanoi, Vietnam.; University of Athens, Medical School, GREECE,
Abstract:

Background

Loss to follow-up (LTFU) is viewed as a major challenge in improving retention in HIV treatment. In Vietnam, the reasons for disengagement from clinics and the effect of injection drug use (IDU) on LTFU with unknown outcome (true LTFU) are not well known.

Methods

Patients receiving antiretroviral therapy (ART) from two HIV clinics in Hanoi were included in this observational study between 2007 and 2012, and followed up every 6 months until the end of 2013. The reasons for disengagement from the clinic, and ART status during imprisonment were investigated in patients with a history of IDU to identify true LTFU. The retention rate at 6–54 months and true LTFU rate were calculated. Cox proportional hazards regression models were performed to identify factors associated with true LTFU.

Results

There were 1,431 patients, with a follow-up time of 4,371 person-years (median 2.49 years). At the end of the follow-up period, 71 (5.0%) patients died, 79 (5.5%) transferred to other clinics, 16 (1.1%) disengaged from the clinics, and the calculated true LTFU was 45 (3.1%), with 12-month ART retention rate of 95.3% for the entire study population. Imprisonment was the most frequent reason for disengagement from the clinics. True LTFU correlated significantly with low CD4 count and high plasma viral load, but not history of IDU.

Conclusion

Imprisonment is a major cause of disengagement from HIV care among patients with a history of IDU.
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