Author
Listed:
- Gregory P Bisson
- Tendani Gaolathe
- Robert Gross
- Caitlin Rollins
- Scarlett Bellamy
- Mpho Mogorosi
- Ava Avalos
- Harvey Friedman
- Diana Dickinson
- Ian Frank
- Ndwapi Ndwapi
Abstract
Background: Monitoring the effectiveness of global antiretroviral therapy scale-up efforts in resource-limited settings is a global health priority, but is complicated by high rates of losses to follow-up after treatment initiation. Determining definitive outcomes of these lost patients, and the effects of losses to follow-up on estimates of survival and risk factors for death after HAART, are key to monitoring the effectiveness of global HAART scale-up efforts. Methodology/Principal Findings: A cohort study comparing clinical outcomes and risk factors for death after HAART initiation as reported before and after tracing of patients lost to follow-up was conducted in Botswana's National Antiretroviral Therapy Program. 410 HIV-infected adults consecutively presenting for HAART were evaluated. The main outcome measures were death or loss to follow-up within the first year after HAART initiation. Of 68 patients initially categorized as lost, over half (58.8%) were confirmed dead after tracing. Patient tracing resulted in reporting of significantly lower survival rates when death was used as the outcome and losses to follow-up were censored [1-year Kaplan Meier survival estimate 0.92 (95% confidence interval, 0.88–0.94 before tracing and 0.83 (95% confidence interval, 0.79–0.86) after tracing, log rank P
Suggested Citation
Gregory P Bisson & Tendani Gaolathe & Robert Gross & Caitlin Rollins & Scarlett Bellamy & Mpho Mogorosi & Ava Avalos & Harvey Friedman & Diana Dickinson & Ian Frank & Ndwapi Ndwapi, 2008.
"Overestimates of Survival after HAART: Implications for Global Scale-Up Efforts,"
PLOS ONE, Public Library of Science, vol. 3(3), pages 1-6, March.
Handle:
RePEc:plo:pone00:0001725
DOI: 10.1371/journal.pone.0001725
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