Overestimates of Survival after HAART: Implications for Global Scale-Up Efforts

Gregory P Bisson, Tendani Gaolathe, Robert Gross, Caitlin Rollins, Scarlett Bellamy, Mpho Mogorosi, Ava Avalos, Harvey Friedman, Diana Dickinson, Ian Frank and Ndwapi Ndwapi

PLOS ONE, 2008, vol. 3, issue 3, 1-6

Abstract: Background: Monitoring the effectiveness of global antiretroviral therapy scale-up efforts in resource-limited settings is a global health priority, but is complicated by high rates of losses to follow-up after treatment initiation. Determining definitive outcomes of these lost patients, and the effects of losses to follow-up on estimates of survival and risk factors for death after HAART, are key to monitoring the effectiveness of global HAART scale-up efforts. Methodology/Principal Findings: A cohort study comparing clinical outcomes and risk factors for death after HAART initiation as reported before and after tracing of patients lost to follow-up was conducted in Botswana's National Antiretroviral Therapy Program. 410 HIV-infected adults consecutively presenting for HAART were evaluated. The main outcome measures were death or loss to follow-up within the first year after HAART initiation. Of 68 patients initially categorized as lost, over half (58.8%) were confirmed dead after tracing. Patient tracing resulted in reporting of significantly lower survival rates when death was used as the outcome and losses to follow-up were censored [1-year Kaplan Meier survival estimate 0.92 (95% confidence interval, 0.88–0.94 before tracing and 0.83 (95% confidence interval, 0.79–0.86) after tracing, log rank P

Date: 2008
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0001725

DOI: 10.1371/journal.pone.0001725

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