ArticlePublic health in practice (Oxford, England)2025
Determinants of loss to follow-up among people living with HIV receiving antiretroviral therapy in a universal test and treat setting: A retrospective cohort study in Nepal.
Article in Public health in practice (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: This study aims to assess the cumulative incidence and rate of loss to follow-up (LTFU) among people living with HIV (PLHIV) in Nepal who begin antiretroviral therapy (ART) early, as well as to identify factors associated with LTFU in the context of the universal test and treat approach. Study design: Retrospective cohort study. Methods: We retrospectively analysed nationally representative routine programme data for all PLHIV initiated on ART from February 19, 2017, to February 18, 2020, and followed up until May 10, 2022. LTFU was defined as a client not returning to the HIV clinic for at least 3 months from the date of their last scheduled appointment. We calculated cumulative incidence rate (IR) and used a multivariable Cox proportional hazards regression model to identify factors associated with LTFU, reporting corresponding 95% confidence intervals (CI). Results: Of the 8192 clients included in our sample, 6797 (82.9 %) started ART within seven days following their HIV diagnosis. The overall IR of LTFU was 4.22 (95 % CI = 3.95-4.51) per 100 person years of observation. The cumulative incidence of LTFU increased over time on ART, from 3.81 % (95 % CI = 3.40-4.26) at 6 months, 6.51 % (95 % CI = 5.97-7.09) at 12 months to 13.41 % (95 % CI = 12.51-14.37) at 48 months. In the multivariable model, factors associated with higher odds of LTFU included initiating treatment within 7 days of diagnosis, younger age, being unmarried, belonging to the Dalit caste, having WHO clinical stage 1 at baseline, and initiation on a non-nucleoside reverse transcriptase inhibitors (NNRTI)-based regimen. Among key populations, sex workers, their clients, men who have sex with men and transgender, people who inject drugs were at higher risk of dropout compared to migrants. Conclusions: In this nationwide cohort, the risk of LTFU increased with time on ART. To optimize the test-and-treat strategy in Nepal, it is crucial to address the unique needs of youth and certain key populations and manage any early adverse drug reactions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.