Outcomes of antiretroviral therapy over a 10-year period of expansion: a multicohort analysis of African and Asian HIV programmes

Abstract

Objective: Little is known about the evolution of programme outcomes associated with rapid expansion of ART in resource-limited settings. We describe temporal trends and assess associations with mortality and loss to follow-up (LTFU) in HIV cohorts from 8 countries.

Design: Multi-cohort study using electronic health records.

Methods: Analysis included adults in twenty-five Médecins Sans Frontières supported programmes initiating ART between 2001 and 2011. Kaplan-Meier methods were used to describe time to death or LTFU, and proportional hazards models to assess associations with individual and programme factors.

Conclusion: As ART expands in resource-limited settings, challenges remain in improving access to ART and preventing programme attrition. There is an urgent need for novel and sustainable models of care to increase long-term retention of patients.

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Authors: Anna GRIMSRUD, Suna BALKAN, Esther C CASAS, Johnny LUJAN,  Gilles VAN CUTSEM, Elisabeth POULET, Landon MYER, Mar PUJADES-RODRIGUEZ.

Journal: JAIDS (Journal of Acquired Immune Deficiency Syndromes)

Keywords: Antiretroviral therapy (highly active); loss to follow-up; mortality;
programme outcomes; retention; survival analysis