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Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort.

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Title: Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort.
Authors: Teixeira da Silva, Daniel S. (AUTHOR), Luz, Paula M. (AUTHOR), Lake, Jordan E. (AUTHOR), Cardoso, Sandra W. (AUTHOR), Ribeiro, Sayonara (AUTHOR), Moreira, Ronaldo I. (AUTHOR), Clark, Jesse L. (AUTHOR), Veloso, Valdilea G. (AUTHOR), Grinsztejn, Beatriz (AUTHOR), De Boni, Raquel B. (AUTHOR)
Source: AIDS Care. Feb2017, Vol. 29 Issue 2, p263-267. 5p. 1 Chart, 1 Graph.
Subjects: Mortality risk factors, Chi-squared test, Confidence intervals, HIV infections, Longitudinal method, Research funding, Survival, Proportional hazards models, Patient dropouts, Kaplan-Meier estimator
Geographic Terms: California
Abstract: Retention in early HIV care has been associated with decreased mortality and improved viral suppression, however the consequences of poor retention in early care in Brazil remain unknown. We assessed the effect of poor retention on mortality in a Brazilian HIV-infected clinical cohort. The analysis included ART-naïve, HIV-infected adults linked to care at the Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz between 2000 and 2010, who did not become pregnant nor participate in a clinical trial during the first two years in care (early care). Poor retention in early care was defined as less than 3 out of 4 six-month intervals with a CD4 or HIV-1 RNA laboratory result during early care. Cox proportional hazards models were used to identify factors associated with mortality, and Kaplan–Meier plots were used to describe the survival probability for participants with poor retention versus good retention. Among 1054 participants with a median (interquartile range) follow-up time of 4.2 years (2.6, 6.3), 20% had poor retention in early care and 8% died. Poor retention in early care [adjusted hazard ratio (aHR) 3.09; 95% CI 1.65–5.79], AIDS defining illness (aHR 1.95; 95% CI 1.20–3.18) and lower education (aHR 2.33; 95% CI 1.45–3.75) were associated with increased mortality risk. Our findings highlight the importance of adopting strategies to improve retention in early HIV care. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort.
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  Data: <searchLink fieldCode="AR" term="%22Teixeira+da+Silva%2C+Daniel+S%2E%22">Teixeira da Silva, Daniel S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Luz%2C+Paula+M%2E%22">Luz, Paula M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lake%2C+Jordan+E%2E%22">Lake, Jordan E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cardoso%2C+Sandra+W%2E%22">Cardoso, Sandra W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ribeiro%2C+Sayonara%22">Ribeiro, Sayonara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Moreira%2C+Ronaldo+I%2E%22">Moreira, Ronaldo I.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Clark%2C+Jesse+L%2E%22">Clark, Jesse L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Veloso%2C+Valdilea+G%2E%22">Veloso, Valdilea G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Grinsztejn%2C+Beatriz%22">Grinsztejn, Beatriz</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22De+Boni%2C+Raquel+B%2E%22">De Boni, Raquel B.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22AIDS+Care%22">AIDS Care</searchLink>. Feb2017, Vol. 29 Issue 2, p263-267. 5p. 1 Chart, 1 Graph.
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– Name: Abstract
  Label: Abstract
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  Data: Retention in early HIV care has been associated with decreased mortality and improved viral suppression, however the consequences of poor retention in early care in Brazil remain unknown. We assessed the effect of poor retention on mortality in a Brazilian HIV-infected clinical cohort. The analysis included ART-naïve, HIV-infected adults linked to care at the Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz between 2000 and 2010, who did not become pregnant nor participate in a clinical trial during the first two years in care (early care). Poor retention in early care was defined as less than 3 out of 4 six-month intervals with a CD4 or HIV-1 RNA laboratory result during early care. Cox proportional hazards models were used to identify factors associated with mortality, and Kaplan–Meier plots were used to describe the survival probability for participants with poor retention versus good retention. Among 1054 participants with a median (interquartile range) follow-up time of 4.2 years (2.6, 6.3), 20% had poor retention in early care and 8% died. Poor retention in early care [adjusted hazard ratio (aHR) 3.09; 95% CI 1.65–5.79], AIDS defining illness (aHR 1.95; 95% CI 1.20–3.18) and lower education (aHR 2.33; 95% CI 1.45–3.75) were associated with increased mortality risk. Our findings highlight the importance of adopting strategies to improve retention in early HIV care. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/09540121.2016.1211610
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      – Code: eng
        Text: English
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        PageCount: 5
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      – SubjectFull: Mortality risk factors
        Type: general
      – SubjectFull: Chi-squared test
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      – SubjectFull: Confidence intervals
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      – SubjectFull: HIV infections
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      – SubjectFull: Research funding
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      – SubjectFull: Survival
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      – SubjectFull: Proportional hazards models
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      – SubjectFull: Patient dropouts
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              Text: Feb2017
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