Background
Half of HIV-infected adults who are not eligible for antiretroviral therapy (ART) are lost to follow up (LTFU). However, data about the attrition from enrolment in care to ART eligibility of HIV infected children are scarce.
Methods
Two hundred and eighty two children ineligible for ART at enrolment in care were followed up until ART eligibility. Multivariable analysis was performed using competing risk regression. The 12-month risk of AIDS was calculated using the age and the absolute CD4 cell count as in the HIV Pediatric Prognostic Markers Collaborative Study.
Anzeige
Results
The cumulative incidence of attrition (mortality and LTFU) was 15.6% (95% confidence interval [CI], 11.3-20.5) after six years of follow-up, and the attrition rate was higher during the first year after enrolment. Children with a 12-month risk of AIDS < 3% had a higher risk of LTFU (subdistribution hazard ratio [SHR] 10.77, 95% CI 1.93-60.07) than those with a 12-month risk of AIDS >4%. Those children whose father had died had a lower risk of LTFU (SHR 0.26, 95% CI 0.09-0.75) than those whose parents were alive and were living in a rented house. Children aged 10-14 had a lower risk of LTFU (SHR 0.12, 95% CI 0.03-0.55) than those aged 5-9 years.
Conclusions
A substantial proportion of children ineligible for ART were LTFU before ART eligibility. These findings can be used by HIV programmes to design interventions aimed at reducing the attrition in pre-ART care of HIV infected children in India.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.