The "ART" of linkage: pre-treatment loss to care after HIV diagnosis at two PEPFAR sites in Durban, South Africa.
The "ART" of linkage: pre-treatment loss to care after HIV diagnosis at two PEPFAR sites in Durban, South Africa.
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DOI：
10.1371/journal.pone.0009538
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发表时间：
2010-03-04
期刊：
影响因子：
3.7
通讯作者：
Freedberg KA
中科院分区：
文献类型：
--
作者：
Losina E;Bassett IV;Giddy J;Chetty S;Regan S;Walensky RP;Ross D;Scott CA;Uhler LM;Katz JN;Holst H;Freedberg KA
尽管人们越来越认识到抗逆转录病毒治疗（ART）开始后的随访损失，但人们对最初艾滋病毒检测呈阳性后的治疗前护理损失（PTLC）知之甚少。我们的目的是确定南非新发现的艾滋病毒感染者的PTLC。我们在南非德班的两个提供艾滋病毒和CD4计数检测和艾滋病毒护理的地点收集了南非检测、识别和联系（STIAL）队列患者。我们将PTLC定义为在HIV诊断后8周内没有CD4计数。我们进行了多变量分析以确定与PTLC相关的因素。从2006年11月至2007年5月，在接受艾滋病毒检测并收到检测结果的712人中，有454人（64%）呈艾滋病毒阳性。其中，206例（45%）患有PTLC。如果感染患者居住在距离检测中心≥10公里的地方（RR = 1.37; 95% CI: 1.11-1.71），有结核病治疗病史（RR = 1.26; 95% CI: 1.00-1.58），或由卫生保健提供者推荐而不是自行推荐进行检测（RR = 1.61; 95% CI: 1.22-2.13），则感染患者患PTLC的可能性显著增加。有一种、两种或三种PTLC风险的患者患PTLC的可能性是没有风险因素的患者的1.88倍、2.50倍和3.84倍。在南非德班的两个高流行区，近一半的艾滋病毒感染者在诊断出艾滋病毒后没有进行CD4计数。治疗前护理失失率如此之高，突出表明迫切需要在初次艾滋病毒检测呈阳性后提高与艾滋病毒护理的联系率。
Although loss to follow-up after antiretroviral therapy (ART) initiation is increasingly recognized, little is known about pre-treatment losses to care (PTLC) after an initial positive HIV test. Our objective was to determine PTLC in newly identified HIV-infected individuals in South Africa. We assembled the South African Test, Identify and Link (STIAL) Cohort of persons presenting for HIV testing at two sites offering HIV and CD4 count testing and HIV care in Durban, South Africa. We defined PTLC as failure to have a CD4 count within 8 weeks of HIV diagnosis. We performed multivariate analysis to identify factors associated with PTLC. From November 2006 to May 2007, of 712 persons who underwent HIV testing and received their test result, 454 (64%) were HIV-positive. Of those, 206 (45%) had PTLC. Infected patients were significantly more likely to have PTLC if they lived ≥10 kilometers from the testing center (RR = 1.37; 95% CI: 1.11–1.71), had a history of tuberculosis treatment (RR = 1.26; 95% CI: 1.00–1.58), or were referred for testing by a health care provider rather than self-referred (RR = 1.61; 95% CI: 1.22–2.13). Patients with one, two or three of these risks for PTLC were 1.88, 2.50 and 3.84 times more likely to have PTLC compared to those with no risk factors. Nearly half of HIV-infected persons at two high prevalence sites in Durban, South Africa, failed to have CD4 counts following HIV diagnosis. These high rates of pre-treatment loss to care highlight the urgent need to improve rates of linkage to HIV care after an initial positive HIV test.
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影响因子：
3.8
作者：
Wools-Kaloustian, K;Kimaiyo, S;Tierney, WM
通讯作者：
Tierney, WM
DOI：
10.1097/qai.0b013e3181a44ef2
发表时间：
2009-06-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Bassett IV;Wang B;Chetty S;Mazibuko M;Bearnot B;Giddy J;Lu Z;Losina E;Walensky RP;Freedberg KA
通讯作者：
Freedberg KA
影响因子：
168.9
作者：
Braitstein, P;Brinkhof, MWG;Egger, M
通讯作者：
Egger, M
DOI：
10.1080/09540120701594776
发表时间：
2008-01-01
影响因子：
1.7
作者：
Krebs, D. W.;Chi, B. H.;Stringer, J. S. A.
通讯作者：
Stringer, J. S. A.
影响因子：
4.5
作者：
Amuron B;Namara G;Birungi J;Nabiryo C;Levin J;Grosskurth H;Coutinho A;Jaffar S
通讯作者：
Jaffar S