Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss

The risk of developing AIDS is elevated not only among those with a late HIV diagnosis but also among those lost to care (LTC). The aims were to address the risk of becoming LTC and of clinical progression in LTC patients who re-enter care. Patients were defined as LTC if they had no visit for ≥ 18 ...

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Vydáno v:Scientific Reports Ročník 11; číslo 1; s. 9632 - 13
Hlavní autoři: Mussini, Cristina, Lorenzini, Patrizia, Cozzi-Lepri, Alessandro, Mammone, Alessia, Guaraldi, Giovanni, Marchetti, Giulia, Lichtner, Miriam, Lapadula, Giuseppe, Lo Caputo, Sergio, Antinori, Andrea, d'Arminio Monforte, Antonella, Girardi, Enrico, Pellicanò, Giovanni
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Springer Science and Business Media LLC 05.05.2021
Nature Publishing Group UK
Nature Publishing Group
Nature Portfolio
Témata:
692/308
692/499
692/700
Acquired immune deficiency syndrome
Adolescent
Adolescent; Adult; Disease Progression; Female; Humans; Longitudinal Studies; Male; Middle Aged; Young Adult; HIV Infections; Lost to Follow-Up
Adult
AIDS
Disease Progression
Female
Health care
Health risks
HIV
HIV Infections
Human immunodeficiency virus
Humanities and Social Sciences
Humans
Longitudinal Studies
Lost to Follow-Up
Lost to follow-up, reengagement, retention in care, hiv
Male
Medical research
Medicine
Middle Aged
multidisciplinary
Q
R
Ribonucleic acid
Risk assessment
Risk factors
RNA
Science
Science (multidisciplinary)
Young Adult
ISSN:2045-2322, 2045-2322
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Shrnutí:The risk of developing AIDS is elevated not only among those with a late HIV diagnosis but also among those lost to care (LTC). The aims were to address the risk of becoming LTC and of clinical progression in LTC patients who re-enter care. Patients were defined as LTC if they had no visit for ≥ 18 months. Of these, persons with subsequent visits were defined as re-engaged in care (RIC). Factors associated with becoming LTC and RIC were investigated. The risk of disease progression was estimated by comparing RIC with patients continuously followed. Over 11,285 individuals included, 3962 became LTC, and of these, 1062 were RIC. Older age, presentation with AIDS and with higher HIV-RNA were associated with a reduced risk of LTC. In contrast, lower education level, irregular job, being an immigrant and injecting-drug user were associated with an increased LTC probability. Moreover, RIC with HIV-RNA > 200 copies/mL at the re-entry had a higher risk of clinical progression, while those with HIV-RNA ≤ 200 copies/mL had a higher risk of only non-AIDS progression. Patients re-entering care after being LTC appeared to be at higher risk of clinical progression than those continuously in care. Active strategies for re-engagement in care should be promoted.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-021-88367-5