[The interruption of outpatient clinical care of HIV-infected patients].
OBJECTIVE
To determine factors associated with the interruption of outpatient care of HIV-positive patients.


METHODS
Non-concurrent prospective study carried out in a public AIDS referral center in Belo Horizonte, Brazil. Medical records were reviewed in order to assess factors associated with the interruption of clinical care of HIV patients admitted between 1993 and 1995. Patients should have attended at least one follow-up visit within a period of 7 months. Statistical analysis was carried out using Chi-square and relative hazard (RH) with 95% confidence interval (CI) estimated by Cox Regression Model.


RESULTS
Cumulative incidence of interruption was 54% among 517 patients included in the study (mean follow-up=24.6 months; 26.5/100 person-years). Multivariate analysis indicated that those individuals who had fewer (<2) CD4+ T lymphocyte cell counts (RH=1.94; 95% CI=1.32-2.84) did not have viral load measured (RH=14.94; IC 95%=5.44-41.04), attended <7 medical follow-up visits (RH =2.80; IC 95%=1.89-4.14), did not change clinical category (RH =1.40; IC 95% =1.00-1.93) and did not undergo any anti-retroviral therapy (RH =1.43; IC 95% =1.06-1.93) had independently an increased risk of interrupting clinical care.


CONCLUSIONS
The rate of clinical interruption in this center is high. The results suggest that interruption may be a function of better clinical outcome, i.e. the service may give priority to those patients with more severe clinical condition, and interruption of clinical care may be a marker for future antiretroviral compliance.
Rodrigues
Celeste S
CS
Secretaria Municipal de Saúde, Belo Horizonte, MG, Brasil.
Guimarães
Mark D C
MD
Acurcio
Francisco A
FA
Comini
Cibele C
CC
D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012737:Sex Factors; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data*
Interrupção do acompanhamento clínico ambulatorial de pacientes infectados pelo HIV.