Incidence rate of and factors associated with loss to follow-up in a longitudinal cohort of antiretroviral-treated HIV-infected persons: an AIDS Clinical Trials Group (ACTG) Longitudinal Linked Randomized Trials (ALLRT) analysis.

TitleIncidence rate of and factors associated with loss to follow-up in a longitudinal cohort of antiretroviral-treated HIV-infected persons: an AIDS Clinical Trials Group (ACTG) Longitudinal Linked Randomized Trials (ALLRT) analysis.
Publication TypeJournal Article
Year of Publication2011
AuthorsKrishnan S, Wu K, Smurzynski M, Bosch RJ, Benson CA, Collier AC, Klebert MK, Feinberg J, Koletar SL
Corporate AuthorsALLRT/A5001 Team
JournalHIV Clin Trials
Volume12
Issue4
Pagination190-200
Date Published2011 Jul-Aug
ISSN1528-4336
KeywordsAdult, Aged, Cohort Studies, Female, Follow-Up Studies, HIV Infections, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Prospective Studies
Abstract

PURPOSE: Examine incidence and factors associated with loss to follow-up (LTFU) in the AIDS Clinical Trials Group (ACTG) Longitudinal Linked Randomized Trials (ALLRT) cohort.

METHOD: ALLRT is a prospective cohort of HIV-infected persons randomized to antiretroviral (ARV) regimens/strategies in ACTG trials and followed long-term after the trial ends. Person-years were calculated from ALLRT entry until loss to follow-up (LTFU; defined using off-study reasons or ≥ 3 consecutive missed visits), death/ severe debilitation/site closures, or June 2009 (censored). Poisson regression was used to examine LTFU factors separately among participants who were ARV naïve or ARV experienced at trial entry.

RESULTS: Among 4,630 participants (22,524 person-years), 1,140 were lost to follow-up, 237 died, 29 were severely debilitated, and 443 were at sites that closed. The LTFU incidence was 5.5 and 4.2 per 100 person-years among previously ARV-naïve and ARV-experienced participants, respectively. In both groups, age ≤ 50, site location, being off ARVs, and viral load ≥ 400 copies/mL were associated with a higher risk of LTFU. Among ARV-naïve participants, male sex, education <16 years, intravenous drug use, and cigarette smoking were also associated with LTFU.

CONCLUSION: Knowledge of differential LTFU can help researchers identify participants at risk of LTFU in longitudinal HIV cohorts and design retention strategies, thereby limiting study bias. The identified factors should be included in inverse probability of weighting models to account for LTFU.

DOI10.1310/HCT1204-190
Alternate JournalHIV Clin Trials
PubMed ID22044855
PubMed Central IDPMC3207266
Grant ListAI 38855 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
AI 68634 / AI / NIAID NIH HHS / United States
AI 68636 / AI / NIAID NIH HHS / United States
AI 69434 / AI / NIAID NIH HHS / United States
AI069474 / AI / NIAID NIH HHS / United States
AI069495 / AI / NIAID NIH HHS / United States
P30 AI050410 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069434 / AI / NIAID NIH HHS / United States
U01 AI069474 / AI / NIAID NIH HHS / United States
U01 AI069495 / AI / NIAID NIH HHS / United States