title: Brief Report: Does Most Mortality in Patients on ART Occur in Care or After Lost to Follow-Up? Evidence From the Themba Lethu Clinic, South Africa.
abstract: In resource-limited settings, early mortality on antiretroviral therapy (ART) is approximately 10%; yet, it is unclear how much of that mortality occurs in care or after lost to follow-up. We assessed mortality rates and predictors of death among 12,222 nonpregnant ART-naive adults initiating first-line ART between April 2004 and May 2012 in South Africa, stratified by person-years in care and lost. We found 14.6% of patients died and being lost accounted for a minority of deaths across multiple definitions of loss (population attributable-risk percent ranged from 10.4% to 42.5%). Although mortality rates in patients lost were much higher than in care, most ART-related mortality occurred on treatment.
authors.affiliation: *Health Economics and Epidemiology Research Office (HE2RO), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; †Right to Care, Johannesburg, South Africa; ‡Center for Global Health & Development, Boston University, Boston, MA; and §Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Budgell
authors.forename: Mhairi
authors.initials: M
authors.lastname: Maskew
authors.forename: Lawrence
authors.initials: L
authors.lastname: Long
authors.forename: Ian
authors.initials: I
authors.lastname: Sanne
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D013019:South Africa; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents