J Korean Med Sci.  2016 Mar;31(3):376-381. 10.3346/jkms.2016.31.3.376.

Predictors of Poor Retention in Care of HIV-infected Patients Receiving Antiretroviral Therapy in Korea: Five-Year Hospital-based Retrospective Cohort Study

• Lee S
• Lee SH
• Lee SJ
• Kim KH
• Lee JE
• Cho H
• Lee SG
• Chen DH
• Chung JS
• Kwak IS

• KMID: 2363497
• DOI: http://doi.org/10.3346/jkms.2016.31.3.376

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.

Keyword

HIV; Antiretroviral Therapy; Retention; Visit Constancy

MeSH Terms

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
Anti-HIV Agents

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