Assessment at antiretroviral clinics during TB treatment reduces loss to follow-up among HIV-infected patients.
METHODS
A South African township clinic where loss to follow-up during TB treatment may prevent HIV-infected TB patients from receiving life-saving ART.


OBJECTIVE
To determine factors associated with loss to follow-up during TB treatment.


METHODS
Regression analyses of a cohort of ART-eligible TB patients who commenced TB treatment and were followed for 24 weeks.


RESULTS
Of 111 ART-eligible TB patients, 15 (14%) died in the ensuing 24 weeks. Of the remaining 96 TB patients, 11 (11%) were lost to follow-up. All TB patients lost to follow-up did not initiate ART. Of 85 TB patients in follow-up, 62 (73%) initiated ART 56 days after TB diagnosis (median, IQR 33-77 days) and 31 days after initial assessment at an ART clinic (median, IQR: 18-55 days). The median duration from TB diagnosis to initial assessment at an ART clinic was 19 days (IQR: 7-48 days). At 24 weeks, 6 of 85 (7%) TB patients who presented to an ART clinic for assessment were lost to follow-up, compared to 5 of 11 (45%) TB patients who did not present to an ART clinic for assessment. Logistic regression analysis (adjusted odds ratio = 0.1, 95% confidence interval [95% CI]: 0.03-0.66) and our Cox proportional hazards model (hazard ratio = 0.2, 95% CI: 0.04-0.68) confirmed that assessment at an ART clinic during TB treatment reduced loss to follow-up.


CONCLUSIONS
Assessment at antiretroviral clinics for HIV care by trained health-care providers reduces loss to follow-up among HIV-infected patients with TB.
Department of Medicine, Clinical Infectious Diseases Research Initiative, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Western Province, South Africa. dominiquepepper@gmail.com
Dominique J
DJ
Pepper
Suzaan
S
Marais
Feriyl
F
Bhaijee
Robert J
RJ
Wilkinson
Virginia
V
De Azevedo
Graeme
G
Meintjes
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*