Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008–2013
Identifieur interne : 001939 ( Pmc/Corpus ); précédent : 001938; suivant : 001940Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008–2013
Auteurs : Matthew P. Fox ; Sydney Rosen MpaSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2015.
Abstract
We previously published systematic reviews of retention in care after antiretroviral therapy initiation among general adult populations in sub-Saharan Africa. We estimated 36-month retention at 73% for publications from 2007–2010. This report extends the review to cover 2008–2013 and expands it to all low- and middle-income countries.
We searched PubMed, Embase, Cochrane Register, and ISI Web of Science from January 1, 2008 to December 31, 2013 and abstracts from AIDS and IAS from 2008–2013. We estimated retention across cohorts using simple averages and interpolated missing times through the last time reported. We estimated all-cause attrition (death, loss to follow-up) for patients receiving first-line ART in routine settings in low- and middle-income countries.
We found 123 papers and abstracts reporting retention for 154 patient cohorts and 1,554,773 patients in 42 countries. Overall, 43% of all patients not retained were known to have died. Unweighted averages of reported retention was 78%, 71% and 69% at 12, 24, and 36 months after treatment initiation, respectively. We estimated 36-month retention at 65% in Africa, 80% in Asia, and 64% in Latin America and the Caribbean. From lifetable analysis, we estimated retention at 12, 24, 36, 48 and 60 months at 83%, 74%, 68%, 64% and 60%, respectively.
Retention at 36 months on treatment averages 65–70%. There are several important gaps in the evidence-base, which could be filled by further research, especially in terms of geographic coverage and duration of follow-up.
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DOI: 10.1097/QAI.0000000000000553
PubMed: 25942461
PubMed Central: 4422218
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PMC:4422218Le document en format XML
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Fox</name><affiliation><nlm:aff id="A1">Center for Global Health & Development, Boston University, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand</nlm:aff></affiliation></author><author><name sortKey="Mpa, Sydney Rosen" sort="Mpa, Sydney Rosen" uniqKey="Mpa S" first="Sydney Rosen" last="Mpa">Sydney Rosen Mpa</name><affiliation><nlm:aff id="A1">Center for Global Health & Development, Boston University, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25942461</idno><idno type="pmc">4422218</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422218</idno><idno type="RBID">PMC:4422218</idno><idno type="doi">10.1097/QAI.0000000000000553</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001939</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001939</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008–2013</title><author><name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P" last="Fox">Matthew P. Fox</name><affiliation><nlm:aff id="A1">Center for Global Health & Development, Boston University, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand</nlm:aff></affiliation></author><author><name sortKey="Mpa, Sydney Rosen" sort="Mpa, Sydney Rosen" uniqKey="Mpa S" first="Sydney Rosen" last="Mpa">Sydney Rosen Mpa</name><affiliation><nlm:aff id="A1">Center for Global Health & Development, Boston University, Boston, MA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">We previously published systematic reviews of retention in care after antiretroviral therapy initiation among general adult populations in sub-Saharan Africa. We estimated 36-month retention at 73% for publications from 2007–2010. This report extends the review to cover 2008–2013 and expands it to all low- and middle-income countries.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We searched PubMed, Embase, Cochrane Register, and ISI Web of Science from January 1, 2008 to December 31, 2013 and abstracts from AIDS and IAS from 2008–2013. We estimated retention across cohorts using simple averages and interpolated missing times through the last time reported. We estimated all-cause attrition (death, loss to follow-up) for patients receiving first-line ART in routine settings in low- and middle-income countries.</p></sec><sec id="S3"><title>Results</title><p id="P3">We found 123 papers and abstracts reporting retention for 154 patient cohorts and 1,554,773 patients in 42 countries. Overall, 43% of all patients not retained were known to have died. Unweighted averages of reported retention was 78%, 71% and 69% at 12, 24, and 36 months after treatment initiation, respectively. We estimated 36-month retention at 65% in Africa, 80% in Asia, and 64% in Latin America and the Caribbean. From lifetable analysis, we estimated retention at 12, 24, 36, 48 and 60 months at 83%, 74%, 68%, 64% and 60%, respectively.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Retention at 36 months on treatment averages 65–70%. There are several important gaps in the evidence-base, which could be filled by further research, especially in terms of geographic coverage and duration of follow-up.</p></sec></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>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id><journal-id journal-id-type="pubmed-jr-id">21821</journal-id><journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id><journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id><journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title></journal-title-group><issn pub-type="ppub">1525-4135</issn><issn pub-type="epub">1944-7884</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25942461</article-id><article-id pub-id-type="pmc">4422218</article-id><article-id pub-id-type="doi">10.1097/QAI.0000000000000553</article-id><article-id pub-id-type="manuscript">NIHMS657470</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008–2013</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Fox</surname><given-names>Matthew P</given-names></name><degrees>DSc</degrees><xref rid="FN1" ref-type="author-notes">*</xref><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>MPA</surname><given-names>Sydney Rosen</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A3">3</xref></contrib></contrib-group><aff id="A1"><label>1</label>Center for Global Health & Development, Boston University, Boston, MA, USA</aff><aff id="A2"><label>2</label>Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA</aff><aff id="A3"><label>3</label>Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand</aff><author-notes><corresp id="FN1"><label>*</label>Author for correspondence: Matthew Fox, Crosstown Center 3<sup>rd</sup> floor, 801 Massachusetts Ave, Boston, MA 02118, 617-414-1270, <email>mfox@bu.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>23</day><month>1</month><year>2015</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>5</month><year>2016</year></pub-date><volume>69</volume><issue>1</issue><fpage>98</fpage><lpage>108</lpage><pmc-comment>elocation-id from pubmed: 10.1097/QAI.0000000000000553</pmc-comment>
<abstract><sec id="S1"><title>Background</title><p id="P1">We previously published systematic reviews of retention in care after antiretroviral therapy initiation among general adult populations in sub-Saharan Africa. We estimated 36-month retention at 73% for publications from 2007–2010. This report extends the review to cover 2008–2013 and expands it to all low- and middle-income countries.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We searched PubMed, Embase, Cochrane Register, and ISI Web of Science from January 1, 2008 to December 31, 2013 and abstracts from AIDS and IAS from 2008–2013. We estimated retention across cohorts using simple averages and interpolated missing times through the last time reported. We estimated all-cause attrition (death, loss to follow-up) for patients receiving first-line ART in routine settings in low- and middle-income countries.</p></sec><sec id="S3"><title>Results</title><p id="P3">We found 123 papers and abstracts reporting retention for 154 patient cohorts and 1,554,773 patients in 42 countries. Overall, 43% of all patients not retained were known to have died. Unweighted averages of reported retention was 78%, 71% and 69% at 12, 24, and 36 months after treatment initiation, respectively. We estimated 36-month retention at 65% in Africa, 80% in Asia, and 64% in Latin America and the Caribbean. From lifetable analysis, we estimated retention at 12, 24, 36, 48 and 60 months at 83%, 74%, 68%, 64% and 60%, respectively.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Retention at 36 months on treatment averages 65–70%. There are several important gaps in the evidence-base, which could be filled by further research, especially in terms of geographic coverage and duration of follow-up.</p></sec></abstract><kwd-group><kwd>retention</kwd><kwd>attrition</kwd><kwd>loss to follow-up</kwd><kwd>HIV</kwd><kwd>antiretroviral therapy</kwd><kwd>meta-analysis</kwd><kwd>systematic review</kwd><kwd>low and middle income countries</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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