Program Schedule

1552
Predictors of poor retention in care among HIV-infected Patients receiving antiretroviral therapy in South Korea: results from a five-year retrospective hospital-based cohort

Session: Poster Abstract Session: HIV: Cascade of Care
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Several recent studies have shown that poor retention in care is associated with higher rate of antiretroviral therapy (ART) failure and worse survival. Identifying which patients are at greatest risk for not being retained is important to target intervention efforts to those groups. The objective of this study was to determine the risk factors for suboptimal retention in care among HIV infected adults receiving ART in Korea.

Methods: A five-year retrospective hospital based cohort study was conducted to assess the risk factors associated with suboptimal retention in care among HIV-infected patients initiating ART during 2002-2008. Patients who never return to hospital after loss to follow-up (LTFU) were traced to ascertain survival status. Retention in care was measured by hospital visit constancy (HVC) during the observation period after initiating ART. To determine the predictable factors for poor retention in care, we compared the demographic, psychosocial, and clinical characteristics between the patients with 100% HVC and the patients with ≤ 50% HVC, by using multiple logistic regression analysis.

Results: Among 247 patients initiating ART during 2002-2008, as of 5 years after ART initiation, 179 patients (72.5%) remained in care in the study hospital, 20 patients (8.1%) were transferred out to other hospitals, 9 patients (3.6%) died in the study hospital, and 39 patients (15.8%) were lost. Of the 39 patients initially categorized as lost, after tracing, 8 patients (20.5%) were known to have died and 31 patients (79.5%) were alive. When we compared 166 patients (67.2%) with HVC 100% with 33 patients (13.4%) with HVC ≤  50%, in multivariate analysis, age at start of ART ≤ 30 years [odds ratio (OR), 4.08 versus > 50; 95% confidence interval (CI), 1.10-15.15, P = 0.036), no non-HIV related comorbidity [OR, 2.94 versus Charlson Comorbidity Index (CCI) ≥ 1; 95% CI, 1.02-8.49, P = 0.046], CD4 cell counts > 300 cells/μL at ART initiation (OR, 3.58; 95% CI, 1.33-9.65, P= 0.012) were significant predictable factors of poor retention in care during up to 5-year observational period after ART initiation.

Conclusion: Younger age, fewer non-HIV related comorbidity, and higher CD4 cell counts at ART initiation were significant risk factors for not being retained, highlighting the importance of special attention to these groups.

Sun Hee Lee, MD, PhD1, Shinwon Lee, MD, PhD1 and Su Jin Lee, MD2, (1)Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea, (2)Internal Medicine, Pusan national university yangsan hospital, yangsansi, South Korea

Disclosures:

S. H. Lee, None

S. Lee, None

S. J. Lee, None

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