title: Early loss to follow-up and mortality of HIV-infected patients diagnosed after the era of antiretroviral treatment scale up: a call for re-invigorating the response in Iran.
abstract: In Iran, the HIV/AIDS epidemic is growing during an era of scaling up the national surveillance system and antiretroviral therapy programs. We examined the early loss to follow-up and mortality rates in a retrospective cohort of 1495 HIV-infected patients by survival proportional hazard Cox model. We also conducted a data abstraction sub-study in a systematic random sample of 147 patients to assess the association between mortality and predictor factors. Overall, 17.3% patients were not seen after their first visit and 17.4% more were lost by 6 months. The overall mortality rate was 7.0 (95% CI 6.1-8.1) per 100 person-years. Moreover, crude mortality rate was higher in men (8.6) than in women (1.7), with an age-adjusted hazard ratio for men compared to women of 4.55 (95% CI 2.31-8.93). Lastly, history of tuberculosis and not being on antiretroviral therapy were significantly associated with higher mortality in the patient sub-sample.
authors: Iranian Research Center for HIV/AIDS, Iran.
authors: Banafsheh Moradmand
authors: BM
authors: Badie
authors: Ghaemeh
authors: G
authors: Nabaei
authors: Mehrnaz
authors: M
authors: Rasoolinejad
authors: Ali
authors: A
authors: Mirzazadeh
authors: Willi
authors: W
authors: McFarland
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; Iran; antiretroviral therapy; epidemiology; loss to follow-up; mortality rate; treatment; viral disease