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Home >> Publications >> Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression.

Publication

Author(s):

Nglazi MD, Kaplan R, Orrell C, Myer L, Wood R, Bekker LG, Lawn SD.

Pub Title:

Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression.

Pub Date:

Mar 31 2013

Pub Region(s):

Southern Africa

Journal Issue:

3

Page Number:
e579907

Journal:

Title: 
PLoS One
Link: 
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057907

PubMed: 23472118
Pub PDF: PDF icon 23472118.pdf

Abstract
OBJECTIVES
: To determine the proportion, characteristics and outcomes of patients who transfer-out from an antiretroviral therapy (ART) service in a South African township.

METHODS: This retrospective cohort study included all patients aged ≥15 years who enrolled between September 2002 and December 2009. Follow-up data were censored in December 2010. Kaplan-Meier survival analysis was used to describe time to transfer-out and cox proportional hazard analysis was used to determine associated risk factors.

RESULTS: 4511 patients (4003 ART-naïve and 508 non-naïve at baseline) received ART during the study period. Overall, 597 (13.2%) transferred out. The probability of transferring out by one year of ART steadily increased from 1.4% in 2002/2004 cohort to 8.9% for the 2009 cohort. Independent risk factors for transfer-out were more recent calendar year of enrolment, younger age (≤25 years) and being ART non-naïve at baseline (i.e., having previously transferred into this clinic from another facility). The proportions of patients transferred out who had a CD4 cell count <200 cells/µL and/or a viral load ≥1000 copies/mL were 19% and 20%, respectively.

CONCLUSIONS: With scale-up of ART over time, an increasing proportion of patients are transferring between ART services and information systems are needed to track patients. Approximately one-fifth of these have viral loads >1000 copies/mL around the time of transfer, suggesting the need for careful adherence counseling and assessment of medication supplies among those planning transfer.

PMID: 23472118 [PubMed - in process]

PMCID: PMC3589459

 

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Citation:

Nglazi MD, Kaplan R, Orrell C, Myer L, Wood R, Bekker LG, Lawn SD. Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression. PLoS One. 2013;8(3):e57907. doi: 10.1371/journal.pone.0057907. Epub 2013 Mar 5. PubMed PMID: 23472118; PubMed Central PMCID: PMC3589459.