ArticlePloS one2017
High rates of loss to follow-up during the first year of pre-antiretroviral therapy for HIV patients at sites providing pre-ART care in Nigeria, 2004-2012.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The HIV care cascade in sub-Saharan Africa: systematic review of published criteria and definitions.Journal of the International AIDS Society · 2021Pooled it
- Trends, magnitude and determinants of viral load suppression among HIV patients on highly active anti-retroviral therapy in Tigray region, Ethiopia: a retrospective study (2016-2024).BMC infectious diseases · 2026Article
- Incidence and predictors of loss to follow-up among adult HIV patients attending antiretroviral therapy at public health facilities in Agaro town, Southwest Ethiopia, 2023.BMC infectious diseases · 2025Article
- Long-term outcomes of rapid antiretroviral NNRTI-based initiation among Thai youth living with HIV: a national registry database study.Journal of the International AIDS Society · 2023Article
- Predictors of the observed high prevalence of loss to follow-up in ART-experienced adult PLHIV: a retrospective longitudinal cohort study in the Tanga Region, Tanzania.BMC infectious diseases · 2023Article
- Incidence and predictors of loss to follow-up among adult HIV-infected patients taking antiretroviral therapy at North Shewa zone public Hospitals, Northeast Ethiopia: A retrospective follow-up study.African health sciences · 2022Article
- Same-day antiretroviral therapy initiation hub model at the Thai Red Cross Anonymous Clinic in Bangkok, Thailand: an observational cohort study.Journal of the International AIDS Society · 2021Observational
- Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000-2020.BMC public health · 2021Article
- A 17 year experience of attrition from care among HIV infected children in Nnewi South-East Nigeria.BMC infectious diseases · 2021Article
- Retention of a cohort of men who have sex with men and transgender women at risk for and living with HIV in Abuja and Lagos, Nigeria: a longitudinal analysis.Journal of the International AIDS Society · 2020Article
- Rapid antiretroviral initiation among Thai youth living with HIV in the National AIDS programme in the era of treatment at any CD4 cell count: a national registry database study.Journal of the International AIDS Society · 2020Article
- Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004-2017).AIDS research and therapy · 2019Article
- Predictors associated with HIV/AIDS patients dropout from antiretroviral therapy at Mettu Karl Hospital, southwest Ethiopia.BMC research notes · 2019Article
- Status of HIV-infected patients classified as lost to follow up from a large antiretroviral program in southwest Nigeria.PloS one · 2019Article
- Effect of Baseline Symptom Manifestations on Retention in Care and Treatment among HIV-Infected Patients in Nigeria.Journal of the International Association of Providers of AIDS CareArticle
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12 authors.
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Abstract
backgroundWith about 3.4 million HIV-infected persons, Nigeria has the second highest number of people living with HIV (PLHIV) in the world. However, antiretroviral treatment (ART) coverage in Nigeria remains low with only 748,846 (22%) of PLHIV on ART by the end of 2014. Retention of HIV-infected patients in pre-ART care is essential to ensure timely ART initiation. We assessed outcomes of patients enrolled in Nigeria's pre-ART program during 2004-2012.
methodsWe conducted a nationally representative retrospective cohort study among adults (≥15 years old), enrolling in pre-ART programs supported by the U.S. President's Emergency Plan for AIDS Relief in Nigeria. A total of 35 sites enrolling ≥50 patients in pre-ART were selected using probability proportional-to-size sampling; 2,415 eligible medical records at these sites were randomly selected for abstraction. Determinants of loss to follow-up (LTFU) and mortality during pre-ART care were estimated using Cox proportional hazards regression models.
resultsThe median age at enrollment was 32 years (interquartile range (IQR) 27-40). A total of 1,216 (51.4%) initiated ART by the time of data abstraction. Among the remaining 1,199 patients, 898 (74.9%) had been LTFU, 180 (15.0%) were alive and in pre-ART care, 71 (5.9%) had died, 50 (4.2%) had transferred out or stopped care. Baseline markers of advanced disease, including weight <45 kg (adjusted hazard ration (AHR) = 4.23; 95% confidence interval (CI): 1.51-15.58) and more advanced WHO disease stage, were predictive of pre-ART mortality. Compared with patients aged 15-24, patients aged 35-44 (AHR = 0.67; 95% CI: 1.0.47-0.95) and age 45-54 (AHR = 0.66; 95% CI: 0.48-0.91) had lower LTFU rates. Compared with attending facilities in North Central geopolitical zone, attending facility locations in South East (AHR = 0.44; 95% CI: 0.24-0.83) was protective against LTFU.
conclusionsAbout half of patients enrolling in HIV program during 2004-2012 in Nigeria had not initiated ART by 2013. Key strategies to improve early ART initiation among pre-ART enrollees include implementation of the WHO test and treat guidelines, earlier HIV testing, and better monitoring to improve ART initiation rates. Further research to understand regional variations in pre-ART outcomes is warranted.
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