Brief Report: Mortality after Loss to Follow-Up - A Linkage Study of People Living with HIV in Thailand and Malaysia
Issued Date
2022-11-01
Resource Type
ISSN
15254135
eISSN
10779450
Scopus ID
2-s2.0-85140274210
Pubmed ID
35969472
Journal Title
Journal of Acquired Immune Deficiency Syndromes
Volume
91
Issue
3
Start Page
290
End Page
295
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Acquired Immune Deficiency Syndromes Vol.91 No.3 (2022) , 290-295
Suggested Citation
Jiamsakul A., Gani Y., Avihingsanon A., Azwa I., Chaiwarith R., Khusuwan S., Ross J., Law M., Kiertiburanakul S. Brief Report: Mortality after Loss to Follow-Up - A Linkage Study of People Living with HIV in Thailand and Malaysia. Journal of Acquired Immune Deficiency Syndromes Vol.91 No.3 (2022) , 290-295. 295. doi:10.1097/QAI.0000000000003067 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85415
Title
Brief Report: Mortality after Loss to Follow-Up - A Linkage Study of People Living with HIV in Thailand and Malaysia
Author's Affiliation
Ramathibodi Hospital
Hospital Sungai Buloh
The Kirby Institute
The HIV Netherlands Australia Thailand Research Collaboration
University of Malaya Medical Centre
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hospital Sungai Buloh
The Kirby Institute
The HIV Netherlands Australia Thailand Research Collaboration
University of Malaya Medical Centre
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Other Contributor(s)
Abstract
Background:Linkage studies have reported high rates of previously unascertained mortality among people living with HIV (PLHIV) who have been lost to follow-up (LTFU). We assessed survival outcomes among PLHIV who were LTFU in Thailand and Malaysia, through linkages to a national death registry or HIV database.Methods:Data linkages with the national death registry or national HIV database were conducted in 2020 on all PLHIV who met LTFU criteria while enrolled in care at participating HIV clinical sites. LTFU was defined as having no documented clinical contact in the previous year, excluding transfers and deaths. Survival time was analyzed using the Cox regression, stratified by site.Results:Data linkages were performed for 489 PLHIV who had been LTFU at sites in Malaysia (n = 2) and Thailand (n = 4). There were 151 (31%) deaths after being LTFU; the mortality rate was 4.89 per 100 person-years. Risk factors for mortality after being LTFU were older age [41-50 years: hazard ratio (HR) = 1.99, 95% confidence interval (CI): 1.08 to 3.68; and older than 50 years: HR = 4.93, 95% CI: 2.63 to 9.22; vs. age 30 years or younger]; receiving NRTI + PI (HR = 1.87, 95% CI: 1.22 to 2.85 vs. NRTI + NNRTI); positive hepatitis C antibody (HR = 2.25, 95% CI: 1.40 to 3.62); and having previous AIDS illness (HR = 1.45, 95% CI: 1.03 to 2.05). An improved survival was seen with a higher CD4 count (CD4 351-500 cells/µL: HR = 0.40, 95%CI: 0.21-0.76; and CD4 >500 cells/µL: HR = 0.43, 95%CI: 0.25-0.75; vs. CD4 ≤200 cells/µL).Conclusions:Almost one-third of PLHIV who were LTFU in this cohort had died while out of care, emphasizing the importance of efforts to reengage PLHIV after they have been LTFU and ensure they have access to ongoing ART.