HIV medical care interruption among people living with HIV in Spain, 2004-2020
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: We estimated the incidence rate of HIV medical care interruption (MCI) and its evolution over a 16-year-period, and identified associated risk factors among HIV-positive individuals from the Cohort of the Spanish AIDS Research Network in 2004-2020.
DESIGN: We included antiretroviral-naive individuals aged at least 18 years at enrolment, recruited between January 1, 2004, and August 30, 2019, and followed-up until November 30, 2020.
METHODS: Individuals with any time interval of at least 15 months between two visits were defined as having a MCI. We calculated the incidence rate (IR) of having at least one MCI and used multivariable Poisson regression models to identify associated risk factors.
RESULTS: Of 15 274 individuals, 5481 (35.9%) had at least one MCI. Of those, 2536 (46.3%) returned to HIV care after MCI and 3753 (68.5%) were lost to follow-up at the end of the study period. The incidence rate (IR) of MCI was 7.2/100 person-years (py) [95% confidence interval (CI): 7.0-7.4]. The annual IR gradually decreased from 20.5/100 py (95% CI: 16.4-25.6) in 2004 to 4.9/100 py (95% CI: 4.4-5.5) in 2014, a slight increase was observed between 2015 and 2018, reaching 9.3/100 py (95% CI: 8.6-10.2) in 2019. Risk factors for MCI included younger age, lower educational level, having contracted HIV infection through injecting drug use or heterosexual intercourse, having been born outside of Spain, and CD4 + cell count >200 cell/μl, viral load <100 000 and co-infection with hepatitis C virus at enrolment.
CONCLUSIONS: Around a third of individuals had at least one MCI during the follow-up. Identified predictors of MCI can help health workers to target and support most vulnerable individuals.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
AIDS (London, England) - 37(2023), 8 vom: 01. Juli, Seite 1277-1284 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Izquierdo, Rebeca [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Retroviral Agents |
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| Anmerkungen: |
Date Completed 07.11.2023 Date Revised 12.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/QAD.0000000000003552 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM354444573 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: We estimated the incidence rate of HIV medical care interruption (MCI) and its evolution over a 16-year-period, and identified associated risk factors among HIV-positive individuals from the Cohort of the Spanish AIDS Research Network in 2004-2020 | ||
| 520 | |a DESIGN: We included antiretroviral-naive individuals aged at least 18 years at enrolment, recruited between January 1, 2004, and August 30, 2019, and followed-up until November 30, 2020 | ||
| 520 | |a METHODS: Individuals with any time interval of at least 15 months between two visits were defined as having a MCI. We calculated the incidence rate (IR) of having at least one MCI and used multivariable Poisson regression models to identify associated risk factors | ||
| 520 | |a RESULTS: Of 15 274 individuals, 5481 (35.9%) had at least one MCI. Of those, 2536 (46.3%) returned to HIV care after MCI and 3753 (68.5%) were lost to follow-up at the end of the study period. The incidence rate (IR) of MCI was 7.2/100 person-years (py) [95% confidence interval (CI): 7.0-7.4]. The annual IR gradually decreased from 20.5/100 py (95% CI: 16.4-25.6) in 2004 to 4.9/100 py (95% CI: 4.4-5.5) in 2014, a slight increase was observed between 2015 and 2018, reaching 9.3/100 py (95% CI: 8.6-10.2) in 2019. Risk factors for MCI included younger age, lower educational level, having contracted HIV infection through injecting drug use or heterosexual intercourse, having been born outside of Spain, and CD4 + cell count >200 cell/μl, viral load <100 000 and co-infection with hepatitis C virus at enrolment | ||
| 520 | |a CONCLUSIONS: Around a third of individuals had at least one MCI during the follow-up. Identified predictors of MCI can help health workers to target and support most vulnerable individuals | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Blanco, José Ramón |e verfasserin |4 aut | |
| 700 | 1 | |a Asensi, Víctor |e verfasserin |4 aut | |
| 700 | 1 | |a Cervero, Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Curran, Adrian |e verfasserin |4 aut | |
| 700 | 1 | |a Rubio, Rafael |e verfasserin |4 aut | |
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