UNASSIGNED: a retrospective cohort analysis was conducted at the Nkongsamba Regional Hospital between 2002 and 2020, using routine data to compare the cumulative incidence of loss to follow-up (LTFU) and mortality between PLHIV initiated on ART under UTT guidelines and those initiated under the standard deferred approach. Chi-squared test was used to compare the risk of attrition between the guideline periods while multiple logistic regression modelling was used to adjust for confounders.
UNASSIGNED: of 1627 PLHIV included for analysis, 756 (46.47%) were enrolled during the era of UTT with 545 (33.54%) initiated on ART on the same day of HIV diagnosis. The transition to the UTT era was associated with an overall reduction in the risk of LTFU by 73% (aOR = 0.27, 95%CI: 0.17 - 0.45). There was modest evidence that the odds of mortality had increased under the UTT policy by about 3-fold (aOR = 2.86, 95%CI: 0.91-8.94). Same-day initiation had no overall effect on LTFU or mortality. LTFU was lower among the same-day initiators in the first 24 months but increased thereafter above the rate among late initiators.
UNASSIGNED: overall ART programme implementation under the UTT has led to a significant decline in LTFU though mortality appeared to have increased. Ongoing efforts to keep patients on long-term treatment should be sustained while other innovative schemes are sought.
■于2002年至2020年在Nkongsamba地区医院进行了一项回顾性队列分析,使用常规数据比较了在UTT指南下接受ART治疗的PLHIV和在标准延期治疗下接受治疗的PLHIV之间的累积随访失败发生率(LTFU)和死亡率。卡方检验用于比较指南期之间的流失风险,而多元逻辑回归模型用于调整混杂因素。
■包括用于分析的1627例PLHIV,在UTT时代招募了756人(46.47%),其中545人(33.54%)在HIV诊断的同一天开始接受ART。向UTT时代的过渡与LTFU风险总体降低73%相关(aOR=0.27,95CI:0.17-0.45)。有适度的证据表明,在UTT政策下,死亡率增加了约3倍(aOR=2.86,95CI:0.91-8.94)。当天开始对LTFU或死亡率没有总体影响。在前24个月中,当天的发起人的LTFU较低,但此后的LTFU高于晚期发起人的比率。
■在UTT下实施的整体ART计划导致LTFU显着下降,尽管死亡率似乎有所增加。在寻求其他创新方案的同时,应继续努力使患者长期接受治疗。