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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">High Retention in Care Among HIV-Infected Patients Entering Care With CD4 Levels >350 cells/μL Under Routine Program Conditions in Uganda</title>
<author><name sortKey="Namusobya, Jennifer" sort="Namusobya, Jennifer" uniqKey="Namusobya J" first="Jennifer" last="Namusobya">Jennifer Namusobya</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Semitala, Fred C" sort="Semitala, Fred C" uniqKey="Semitala F" first="Fred C." last="Semitala">Fred C. Semitala</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2"><institution>Makerere University College of Health Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Amanyire, Gideon" sort="Amanyire, Gideon" uniqKey="Amanyire G" first="Gideon" last="Amanyire">Gideon Amanyire</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kabami, Jane" sort="Kabami, Jane" uniqKey="Kabami J" first="Jane" last="Kabami">Jane Kabami</name>
<affiliation><nlm:aff id="af3"><institution>Infectious Diseases Research Collaboration and SEARCH Collaboration, Kampala, Uganda</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chamie, Gabriel" sort="Chamie, Gabriel" uniqKey="Chamie G" first="Gabriel" last="Chamie">Gabriel Chamie</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bogere, John" sort="Bogere, John" uniqKey="Bogere J" first="John" last="Bogere">John Bogere</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jain, Vivek" sort="Jain, Vivek" uniqKey="Jain V" first="Vivek" last="Jain">Vivek Jain</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Clark, Tamara D" sort="Clark, Tamara D" uniqKey="Clark T" first="Tamara D." last="Clark">Tamara D. Clark</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Charlebois, Edwin" sort="Charlebois, Edwin" uniqKey="Charlebois E" first="Edwin" last="Charlebois">Edwin Charlebois</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Havlir, Diane V" sort="Havlir, Diane V" uniqKey="Havlir D" first="Diane V." last="Havlir">Diane V. Havlir</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kamya, Moses" sort="Kamya, Moses" uniqKey="Kamya M" first="Moses" last="Kamya">Moses Kamya</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2"><institution>Makerere University College of Health Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Geng, Elvin H" sort="Geng, Elvin H" uniqKey="Geng E" first="Elvin H." last="Geng">Elvin H. Geng</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23899683</idno>
<idno type="pmc">3792723</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792723</idno>
<idno type="RBID">PMC:3792723</idno>
<idno type="doi">10.1093/cid/cit490</idno>
<date when="2013">2013</date>
<idno type="wicri:Area/Pmc/Corpus">001653</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001653</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">High Retention in Care Among HIV-Infected Patients Entering Care With CD4 Levels >350 cells/μL Under Routine Program Conditions in Uganda</title>
<author><name sortKey="Namusobya, Jennifer" sort="Namusobya, Jennifer" uniqKey="Namusobya J" first="Jennifer" last="Namusobya">Jennifer Namusobya</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Semitala, Fred C" sort="Semitala, Fred C" uniqKey="Semitala F" first="Fred C." last="Semitala">Fred C. Semitala</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2"><institution>Makerere University College of Health Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Amanyire, Gideon" sort="Amanyire, Gideon" uniqKey="Amanyire G" first="Gideon" last="Amanyire">Gideon Amanyire</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kabami, Jane" sort="Kabami, Jane" uniqKey="Kabami J" first="Jane" last="Kabami">Jane Kabami</name>
<affiliation><nlm:aff id="af3"><institution>Infectious Diseases Research Collaboration and SEARCH Collaboration, Kampala, Uganda</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chamie, Gabriel" sort="Chamie, Gabriel" uniqKey="Chamie G" first="Gabriel" last="Chamie">Gabriel Chamie</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bogere, John" sort="Bogere, John" uniqKey="Bogere J" first="John" last="Bogere">John Bogere</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jain, Vivek" sort="Jain, Vivek" uniqKey="Jain V" first="Vivek" last="Jain">Vivek Jain</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Clark, Tamara D" sort="Clark, Tamara D" uniqKey="Clark T" first="Tamara D." last="Clark">Tamara D. Clark</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Charlebois, Edwin" sort="Charlebois, Edwin" uniqKey="Charlebois E" first="Edwin" last="Charlebois">Edwin Charlebois</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Havlir, Diane V" sort="Havlir, Diane V" uniqKey="Havlir D" first="Diane V." last="Havlir">Diane V. Havlir</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kamya, Moses" sort="Kamya, Moses" uniqKey="Kamya M" first="Moses" last="Kamya">Moses Kamya</name>
<affiliation><nlm:aff id="af1"><institution>Makerere University Joint AIDS Program</institution>
</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2"><institution>Makerere University College of Health Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Geng, Elvin H" sort="Geng, Elvin H" uniqKey="Geng E" first="Elvin H." last="Geng">Elvin H. Geng</name>
<affiliation><nlm:aff id="af4"><institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</title>
<idno type="ISSN">1058-4838</idno>
<idno type="eISSN">1537-6591</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Accounting for outcomes among those lost to follow-up in a Ugandan HIV treatment program among patients entering care with a CD4 count >350 cells/µL and not immediately eligible for antiretroviral therapy reveals retention to be higher than most prevailing estimates.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">cid</journal-id>
<journal-id journal-id-type="hwp">cid</journal-id>
<journal-title-group><journal-title>Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</journal-title>
</journal-title-group>
<issn pub-type="ppub">1058-4838</issn>
<issn pub-type="epub">1537-6591</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23899683</article-id>
<article-id pub-id-type="pmc">3792723</article-id>
<article-id pub-id-type="doi">10.1093/cid/cit490</article-id>
<article-id pub-id-type="publisher-id">cit490</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>HIV/AIDS</subject>
</subj-group>
</article-categories>
<title-group><article-title>High Retention in Care Among HIV-Infected Patients Entering Care With CD4 Levels >350 cells/μL Under Routine Program Conditions in Uganda</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Namusobya</surname>
<given-names>Jennifer</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Semitala</surname>
<given-names>Fred C.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amanyire</surname>
<given-names>Gideon</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kabami</surname>
<given-names>Jane</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chamie</surname>
<given-names>Gabriel</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bogere</surname>
<given-names>John</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jain</surname>
<given-names>Vivek</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Clark</surname>
<given-names>Tamara D.</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Charlebois</surname>
<given-names>Edwin</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Havlir</surname>
<given-names>Diane V.</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kamya</surname>
<given-names>Moses</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Geng</surname>
<given-names>Elvin H.</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
</contrib-group>
<aff id="af1"><label>1</label>
<institution>Makerere University Joint AIDS Program</institution>
</aff>
<aff id="af2"><label>2</label>
<institution>Makerere University College of Health Sciences</institution>
</aff>
<aff id="af3"><label>3</label>
<institution>Infectious Diseases Research Collaboration and SEARCH Collaboration, Kampala, Uganda</institution>
</aff>
<aff id="af4"><label>4</label>
<institution>Department of Medicine, University of California</institution>
<institution>, San Francisco</institution>
</aff>
<author-notes><corresp>Correspondence: Elvin H. Geng, MD, MPH, Positive Health Program, San Francisco General Hospital, 995 Potrero Ave, Bldg 80, Box 0874, San Francisco, CA 94110 (<email>genge@php.ucsf.edu</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>1</day>
<month>11</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>7</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>11</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>57</volume>
<issue>9</issue>
<fpage>1343</fpage>
<lpage>1350</lpage>
<history><date date-type="received"><day>25</day>
<month>3</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>23</day>
<month>7</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: <email>journals.permissions@oup.com</email>
.</copyright-statement>
<copyright-year>2013</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="cit490.pdf"></self-uri>
<abstract abstract-type="precis"><p>Accounting for outcomes among those lost to follow-up in a Ugandan HIV treatment program among patients entering care with a CD4 count >350 cells/µL and not immediately eligible for antiretroviral therapy reveals retention to be higher than most prevailing estimates.</p>
</abstract>
<abstract><p><bold><italic>Background.</italic>
</bold>
In Africa, human immunodeficiency virus (HIV)–infected patients who present to care with CD4 levels >350 cells/µL (ie, current antiretroviral treatment thresholds) are often thought to be poorly retained in care, but most estimates do not account for outcomes among patients lost to follow-up.</p>
<p><bold><italic>Methods.</italic>
</bold>
We evaluated HIV-infected adults who had made a visit in the last 2.5 years in a program in Uganda. We identified a random sample of patients lost to follow-up (9 months without a visit). Ascertainers sought patients in the community in this sample and outcomes were incorporated into revised survival estimates of mortality and retention for the clinic population using a probability weight.</p>
<p><bold><italic>Results.</italic>
</bold>
Of 6473 patients, (29% male, median age 29 years, median CD4 count 550 cells/µL), 1294 (20%) became lost to follow-up over 2.5 years. Two hundred seven (16%) randomly selected lost patients were sought, and in 175 (85%) vital status was ascertained. In 19 of 175 (11%), the patient had died. Of the 156 (89%) alive, 74 (47%) were interviewed in person, and 38 of 74 (51%) reported HIV care elsewhere, whereas 36 of 74 (49%) were not in care. Application of weights derived from sampling found that at 2.5 years, retention among patients who enrolled with CD4 levels >350 cells/µL was 88.2% and mortality was 2.5%. Lower income, unemployment, and rural residence were associated with failure to be retained.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Retention in patients entering care with high CD4 counts under routine program conditions in Africa is high in a Ugandan care program and may be systematically underestimated in many other settings.</p>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>Africa</kwd>
<kwd>retention</kwd>
<kwd>CD4</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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