Abstract:
BACKGROUND:Antiretroviral therapy (ART) initiation is now recommended irrespective of CD4 count. However data on the relationship between CD4 count at ART initiation and loss to follow-up (LTFU) are limited and conflicting. METHODS:We conducted a cohort analysis including all adults initiating ART (2008-2012) at three public sector sites in South Africa. LTFU was defined as no visit in the 6 months before database closure. The Kaplan-Meier estimator and Cox's proportional hazards models examined the relationship between CD4 count at ART initiation and 24-month LTFU. Final models were adjusted for demographics, year of ART initiation, programme expansion and corrected for unascertained mortality. RESULTS:Among 17 038 patients, the median CD4 at initiation increased from 119 (IQR 54-180) in 2008 to 257 (IQR 175-318) in 2012. In unadjusted models, observed LTFU was associated with both CD4 counts <100 cells/μL and CD4 counts ≥300 cells/μL. After adjustment, patients with CD4 counts ≥300 cells/μL were 1.35 (95% CI 1.12 to 1.63) times as likely to be LTFU after 24 months compared to those with a CD4 150-199 cells/μL. This increased risk for patients with CD4 counts ≥300 cells/μL was largest in the first 3 months on treatment. Correction for unascertained deaths attenuated the association between CD4 counts <100 cells/μL and LTFU while the association between CD4 counts ≥300 cells/μL and LTFU persisted. CONCLUSIONS:Patients initiating ART at higher CD4 counts may be at increased risk for LTFU. With programmes initiating patients at higher CD4 counts, models of ART delivery need to be reoriented to support long-term retention.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Grimsrud A,Cornell M,Schomaker M,Fox MP,Orrell C,Prozesky H,Stinson K,Tanser F,Egger M,Myer L,International Epidemiologic Databases to Evaluate AIDS Southern Africa Collaboration (IeDEA-SA).doi
10.1136/jech-2015-206629subject
Has Abstractpub_date
2016-06-01 00:00:00pages
549-55issue
6eissn
0143-005Xissn
1470-2738pii
jech-2015-206629journal_volume
70pub_type
杂志文章,多中心研究abstract:STUDY OBJECTIVE:To review the incidence of leukaemia and non-Hodgkin's lymphoma in children and young adults in the area less than 25 km from the Dounreay nuclear installation and the remainder of the Kirkwall postcode area in the full time period for which data are now available (1968-91), and to determine whether the...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.48.3.232
更新日期:1994-06-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to assess the risk of back symptoms in people admitted to hospital because of traffic accidents and falls. DESIGN:The study was a cross sectional survey with information collected by postal questionnaire. Main outcome measures were associations between hospital admission for a traffic accid...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.3.231
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abstract:BACKGROUND:Resource allocation and integration of services have been of interest recently to achieve health-related Millennium Development Goals. This paper analyses the extent to which countries receiving funding in HIV were able to invest in activities in the area of sexual and reproductive health (SRH). METHODS:The...
journal_title:Journal of epidemiology and community health
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doi:10.1136/jech.2009.092940
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abstract:BACKGROUND:The Great East Japan Earthquake and subsequent tsunami and nuclear disaster on 11 March 2011 had a short-term influence on the increase in emergency department visits and hospital admissions due to various diseases. However, it remains unclear whether the earthquake and tsunami disaster affected the long-ter...
journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech-2020-214691
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abstract:OBJECTIVES:To describe the situation of the influenza in Portugal through the estimates of the incidence rates and the identification of the viral strains implicated on it during the period 1990-1996. DESIGN:The integrated clinical and laboratory surveillance system for influenza in Portugal is based on the Portuguese...
journal_title:Journal of epidemiology and community health
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doi:
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abstract:STUDY OBJECTIVE:This study examined the prevalence of body dissatisfaction as a function of individual level and neighbourhood level indicators of affluence. PARTICIPANTS AND SETTING:A subset of data from a larger random digit dialling telephone survey was used to obtain individual level data on body dissatisfaction, ...
journal_title:Journal of epidemiology and community health
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abstract::A case-control study of cancers of the upper alimentary tract was conducted in a hospital to assess the role of several risk factors, including alcohol consumption, which is reported here. Male patients from one community with cancers of the oral cavity (n = 278), pharynx (n = 225), and oesophagus (n = 236) formed the...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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abstract:BACKGROUND:828 elderly subjects residing in nursing homes were followed up during 4 months to ascertain incidence of symptoms associated with Pontiac fever (PF) in a non-epidemic setting. METHODS:The exposure situation was inhalation of Legionella bacteria while showering. An audit of the hot water system in all insti...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.089409
更新日期:2009-12-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
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更新日期:2003-09-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.6.625
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.2007.069765
更新日期:2008-11-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
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更新日期:2013-11-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.45.1.24
更新日期:1991-03-01 00:00:00
abstract::The epidemiology of migraine and non-migrainous headaches (NMH) was investigated in a community survey in a neighbourhood of western Jerusalem in 1969-71. Diagnoses were based on histories taken by physicians. Prevalence rates among persons aged 15 and over were 10.1% for migraine (including classical migraine, 2.1%) ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.34.3.188
更新日期:1980-09-01 00:00:00
abstract::A dangerous distortion of priorities seems to be currently apparent in the dominant approaches to major public health problems, including cardiovascular disease, diabetes, obesity, cancer and some infectious diseases. Relevant examples suggest an apparently inappropriate tendency to prioritise technocratic, partial so...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
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abstract:STUDY OBJECTIVE:The aim was to explore the relationships between five socioeconomic variables and three main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) in Hong Kong. DESIGN:This cross sectional study used data from the 1986 by-census and registered death data f...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:This study examined whether living in rented housing is associated with increased all-cause and cause-specific mortality, and whether the association between home ownership and mortality can be explained by household income, occupational class, and educational level. METHODS:A random sample including every ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00