Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss

Abstract The risk of developing AIDS is elevated not only among those with a late HIV diagnosis but also among those lost to care (LTC). The aims were to address the risk of becoming LTC and of clinical progression in LTC patients who re-enter care. Patients were defined as LTC if they had no visit...

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Autores principales:	Cristina Mussini, Patrizia Lorenzini, Alessandro Cozzi-Lepri, Alessia Mammone, Giovanni Guaraldi, Giulia Marchetti, Miriam Lichtner, Giuseppe Lapadula, Sergio Lo Caputo, Andrea Antinori, Antonella d’Arminio Monforte, Enrico Girardi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d674c39a68c8475b8eb2814588081d50
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spelling	oai:doaj.org-article:d674c39a68c8475b8eb2814588081d502021-12-02T14:29:15ZDeterminants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss10.1038/s41598-021-88367-52045-2322https://doaj.org/article/d674c39a68c8475b8eb2814588081d502021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88367-5https://doaj.org/toc/2045-2322Abstract The risk of developing AIDS is elevated not only among those with a late HIV diagnosis but also among those lost to care (LTC). The aims were to address the risk of becoming LTC and of clinical progression in LTC patients who re-enter care. Patients were defined as LTC if they had no visit for ≥ 18 months. Of these, persons with subsequent visits were defined as re-engaged in care (RIC). Factors associated with becoming LTC and RIC were investigated. The risk of disease progression was estimated by comparing RIC with patients continuously followed. Over 11,285 individuals included, 3962 became LTC, and of these, 1062 were RIC. Older age, presentation with AIDS and with higher HIV-RNA were associated with a reduced risk of LTC. In contrast, lower education level, irregular job, being an immigrant and injecting-drug user were associated with an increased LTC probability. Moreover, RIC with HIV-RNA > 200 copies/mL at the re-entry had a higher risk of clinical progression, while those with HIV-RNA ≤ 200 copies/mL had a higher risk of only non-AIDS progression. Patients re-entering care after being LTC appeared to be at higher risk of clinical progression than those continuously in care. Active strategies for re-engagement in care should be promoted.Cristina MussiniPatrizia LorenziniAlessandro Cozzi-LepriAlessia MammoneGiovanni GuaraldiGiulia MarchettiMiriam LichtnerGiuseppe LapadulaSergio Lo CaputoAndrea AntinoriAntonella d’Arminio MonforteEnrico GirardiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cristina Mussini Patrizia Lorenzini Alessandro Cozzi-Lepri Alessia Mammone Giovanni Guaraldi Giulia Marchetti Miriam Lichtner Giuseppe Lapadula Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Enrico Girardi Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
description	Abstract The risk of developing AIDS is elevated not only among those with a late HIV diagnosis but also among those lost to care (LTC). The aims were to address the risk of becoming LTC and of clinical progression in LTC patients who re-enter care. Patients were defined as LTC if they had no visit for ≥ 18 months. Of these, persons with subsequent visits were defined as re-engaged in care (RIC). Factors associated with becoming LTC and RIC were investigated. The risk of disease progression was estimated by comparing RIC with patients continuously followed. Over 11,285 individuals included, 3962 became LTC, and of these, 1062 were RIC. Older age, presentation with AIDS and with higher HIV-RNA were associated with a reduced risk of LTC. In contrast, lower education level, irregular job, being an immigrant and injecting-drug user were associated with an increased LTC probability. Moreover, RIC with HIV-RNA > 200 copies/mL at the re-entry had a higher risk of clinical progression, while those with HIV-RNA ≤ 200 copies/mL had a higher risk of only non-AIDS progression. Patients re-entering care after being LTC appeared to be at higher risk of clinical progression than those continuously in care. Active strategies for re-engagement in care should be promoted.
format	article
author	Cristina Mussini Patrizia Lorenzini Alessandro Cozzi-Lepri Alessia Mammone Giovanni Guaraldi Giulia Marchetti Miriam Lichtner Giuseppe Lapadula Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Enrico Girardi
author_facet	Cristina Mussini Patrizia Lorenzini Alessandro Cozzi-Lepri Alessia Mammone Giovanni Guaraldi Giulia Marchetti Miriam Lichtner Giuseppe Lapadula Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Enrico Girardi
author_sort	Cristina Mussini
title	Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
title_short	Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
title_full	Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
title_fullStr	Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
title_full_unstemmed	Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss
title_sort	determinants of loss to care and risk of clinical progression in plwh who are re-engaged in care after a temporary loss
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d674c39a68c8475b8eb2814588081d50
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Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss

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