title: Predictors of Poor Retention in Care of HIV-infected Patients Receiving Antiretroviral Therapy in Korea: Five-Year Hospital-based Retrospective Cohort Study.
abstract: Poor retention in care (RIC) is associated with higher antiretroviral therapy (ART) failure and worse survival. Identifying high risk patients for poor RIC is important for targeted intervention. A retrospective cohort study was conducted at a tertiary care hospital in Korea. HIV-infected patients initiating ART during 2002-2008 were included. 5 year-RIC was measured by hospital visit constancy (HVC) at 5 years after initiating ART. Among 247 enrolled patients, 179 (72.5%) remained in care, 20 (8.1%) were transferred to other hospitals, 9 (3.6%) died and 39 (15.8%) were lost to follow-up. We compared the demographic, psychosocial, and clinical characteristics between the groups with 100% HVC (n = 166, 67.2%) and ≤ 50% HVC (n = 33, 13.4%). In multivariable analysis, ART-starting age ≤ 30 years (odds ratio [OR] 4.08 vs. > 50; 95% confidence interval [CI] 1.10-15.15, P = 0.036), no non-HIV related comorbidity (OR 2.94 vs. comorbidity ≥ 1; 95% CI 1.02-8.49, P = 0.046), baseline CD4 cell count > 300 cells/μL (OR 3.58 vs. ≤ 200; 95% CI 1.33-9.65, P = 0.012) were significant predictable factors of poor RIC. HIV/AIDS care-givers should pay attention to young patients with higher baseline CD4 cell counts and no non-HIV related comorbidity.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Shinwon
authors.identifier: 0000-0001-7652-7093
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Sun Hee
authors.identifier: 0000-0003-2093-3628
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Kye-Hyung
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Heerim
authors.initials: H
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Seung Geun
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Namgu Public Health Center, Busan, Korea .
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea .
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D015331:Cohort Studies; D015897:Comorbidity; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D006761:Hospitals; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral Therapy; HIV; Retention; Visit Constancy