Kranzer, Katharina; Bradley, John; Musaazi, Joseph; Nyathi, Mary; Gunguwo, Hilary; Ndebele, Wedu; Dixon, Mark; Ndhlovu, Mbongeni; Rehman, Andrea; Khan, Palwasha; +3 more... Vogt, Florian; Apollo, Tsitsi; Ferrand, Rashida Abbas; (2017) Loss to follow-up among children and adolescents growing up with HIV infection: age really matters. Journal of the International AIDS Society, 20 (1). 21737-. ISSN 1758-2652 DOI: https://doi.org/10.7448/IAS.20.1.21737
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Abstract
INTRODUCTION: Globally, increasing numbers of HIV-infected children are reaching adolescence due to antiretroviral therapy (ART). We investigated rates of loss-to-follow-up (LTFU) from HIV care services among children as they transition from childhood through adolescence. METHODS: Individuals aged 5-19 years initiated on ART in a public-sector HIV clinic in Bulawayo, Zimbabwe, between 2005 and 2009 were included in a retrospective cohort study. Participants were categorized into narrow age-bands namely: 5-9 (children), 10-14 (young adolescents) and 15-19 (older adolescents). The effect of age at ART initiation, current age (using a time-updated Lexis expansion) and transitioning from one age group to the next on LTFU was estimated using Poisson regression. RESULTS: Of 2273 participants, 1013, 875 and 385 initiated ART aged 5-9, 10-14 and 15-19 years, respectively. Unlike those starting ART as children, individuals starting ART as young adolescents had higher LTFU rates after moving to the older adolescent age-band (Adjusted rate ratio (ARR) 1.54; 95% CI: 0.94-2.55) and similarly, older adolescents had higher LTFU rates after transitioning to being young adults (ARR 1.79; 95% CI: 1.05-3.07). In older adolescents, the LTFU rate among those who started ART in that age-band was higher compared to the rate among those starting ART at a younger age (ARR = 1.70; 95% CI: 1.05, 2.77). This however did not hold true for other age-groups. CONCLUSIONS: Adolescents had higher rates of LTFU compared to other age-groups, with older adolescents at particularly high risk in all analyses. Age-updated analyses that examine movement across narrow age-bands are paramount in understanding how developmental heterogeneity in children affects HIV outcomes.
Item Type | Article |
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Faculty and Department |
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) |
Research Centre | ?? XZIM ?? |
PubMed ID | 28715158 |
ISI | 405567100001 |
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