Loss to follow-up among children and adolescents growing up with HIV infection: age really matters

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dc.contributor.authorKranzer, Katharina.
dc.contributor.authorBradley, John.
dc.contributor.authorMusaazi, Joseph
dc.contributor.authorFerrand, Rashida.A
dc.contributor.authorNdhlovu, Mbongeni
dc.contributor.authorApollo, Tsitsi
dc.date.accessioned2018-11-19T13:26:48Z
dc.date.accessioned2023-06-27T08:51:24Z
dc.date.available2018-11-19T13:26:48Z
dc.date.available2023-06-27T08:51:24Z
dc.date.issued2017-07-17
dc.descriptionopen access journal articleen_US
dc.description.abstractIntroduction: Globally, increasing numbers of HIV-infected children are reaching adolescence due to antiretroviral therapy (ART). We investigated rates of loss-to-follow-up (LTFU) from HIV care services among children as they transition from childhood through adolescence. Methods: Individuals aged 5–19 years initiated on ART in a public-sector HIV clinic in Bulawayo, Zimbabwe, between 2005 and 2009 were included in a retrospective cohort study. Participants were categorized into narrow age-bands namely: 5–9 (children), 10–14 (young adolescents) and 15–19 (older adolescents). The effect of age at ART initiation, current age (using a time-updated Lexis expansion) and transitioning from one age group to the next on LTFU was estimated using Poisson regression. Results: Of 2273 participants, 1013, 875 and 385 initiated ART aged 5–9, 10–14 and 15–19 years, respectively. Unlike those starting ART as children, individuals starting ART as young adolescents had higher LTFU rates after moving to the older adolescent age-band (Adjusted rate ratio (ARR) 1.54; 95% CI: 0.94–2.55) and similarly, older adolescents had higher LTFU rates after transitioning to being young adults (ARR 1.79; 95% CI: 1.05–3.07). In older adolescents, the LTFU rate among those who started ART in that age-band was higher compared to the rate among those starting ART at a younger age (ARR = 1.70; 95% CI: 1.05, 2.77). This however did not hold true for other age-groups. Conclusions: Adolescents had higher rates of LTFU compared to other age-groups, with older adolescents at particularly high risk in all analyses. Age-updated analyses that examine movement across narrow age-bands are paramount in understanding how developmental heterogeneity in children affects HIV outcomes.en_US
dc.description.sponsorshipRAF is funded by the Wellcome Trust through an Intermediate Fellowship [Grant 095878/Z/11/Z]. Salary support for JB and AMR was provided by the UK Medical Research Council through a grant to the LSHTM Tropical Epidemiology Group [Grant MR/K012126/1]. JM was funded by the European & Developing Countries Clinical Trials Partnership Master’s Fellowship [grant code MF.2013.40205.025]. TA is funded through a Fogarty HIV Implementation Science Research Training Programme grant.en_US
dc.identifier.citationKranzer K et al.(2017). Loss to follow-up among children and adolescents growing up with HIV infection: age really matters. Journal of the International AIDS Society, 20.en_US
dc.identifier.issn1758-2652
dc.identifier.urihttp://196.220.97.103:4000/handle/123456789/971
dc.language.isoenen_US
dc.publisherWiley Open Accessen_US
dc.subjectTransitionen_US
dc.subjectAdolescenten_US
dc.subjectHIVen_US
dc.subjectAfricaen_US
dc.subjectLost to follow upen_US
dc.titleLoss to follow-up among children and adolescents growing up with HIV infection: age really mattersen_US
dc.typeArticleen_US
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