Predictors of Poor Retention in Care of HIV-infected Patients Receiving Antiretroviral Therapy in Korea: Five-Year Hospital-based Retrospective Cohort Study.
10.3346/jkms.2016.31.3.376
- Author:
Shinwon LEE
1
;
Sun Hee LEE
;
Su Jin LEE
;
Kye Hyung KIM
;
Jeong Eun LEE
;
Heerim CHO
;
Seung Geun LEE
;
Dong Hwan CHEN
;
Joo Seop CHUNG
;
Ihm Soo KWAK
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea. zzanmery@gmail.com
- Publication Type:Original Article
- Keywords:
HIV;
Antiretroviral Therapy;
Retention;
Visit Constancy
- MeSH:
Adult;
Anti-HIV Agents/*therapeutic use;
CD4 Lymphocyte Count;
CD4-Positive T-Lymphocytes/cytology;
Cohort Studies;
Comorbidity;
Demography;
Female;
HIV Infections/*drug therapy/mortality/psychology;
Hospitals;
Humans;
Male;
*Medication Adherence/psychology;
Middle Aged;
Multivariate Analysis;
Odds Ratio;
Republic of Korea;
Retrospective Studies
- From:Journal of Korean Medical Science
2016;31(3):376-381
- CountryRepublic of Korea
- Language:English
-
Abstract:
Poor retention in care (RIC) is associated with higher antiretroviral therapy (ART) failure and worse survival. Identifying high risk patients for poor RIC is important for targeted intervention. A retrospective cohort study was conducted at a tertiary care hospital in Korea. HIV-infected patients initiating ART during 2002-2008 were included. 5 year-RIC was measured by hospital visit constancy (HVC) at 5 years after initiating ART. Among 247 enrolled patients, 179 (72.5%) remained in care, 20 (8.1%) were transferred to other hospitals, 9 (3.6%) died and 39 (15.8%) were lost to follow-up. We compared the demographic, psychosocial, and clinical characteristics between the groups with 100% HVC (n = 166, 67.2%) and < or = 50% HVC (n = 33, 13.4%). In multivariable analysis, ART-starting age < or = 30 years (odds ratio [OR] 4.08 vs. > 50; 95% confidence interval [CI] 1.10-15.15, P = 0.036), no non-HIV related comorbidity (OR 2.94 vs. comorbidity > or = 1; 95% CI 1.02-8.49, P = 0.046), baseline CD4 cell count > 300 cells/muL (OR 3.58 vs. < or = 200; 95% CI 1.33-9.65, P = 0.012) were significant predictable factors of poor RIC. HIV/AIDS care-givers should pay attention to young patients with higher baseline CD4 cell counts and no non-HIV related comorbidity.