Does most mortality in patients on ART occur in care or after lost to follow-up? evidence from the themba Lethu Clinic, South Africa
Budgell EP., Maskew M., Long L., Sanne I., Fox MP.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. In resource-limited settings, early mortality on antiretroviral therapy (ART) is approximately 10%; yet, it is unclear how much of that mortality occurs in care or after lost to follow-up. We assessed mortality rates and predictors of death among 12,222 nonpregnant ART-naive adults initiating first-line ART between April 2004 and May 2012 in South Africa, stratified by person-years in care and lost. We found 14.6% of patients died and being lost accounted for a minority of deaths across multiple definitions of loss (population attributable-risk percent ranged from 10.4% to 42.5%). Although mortality rates in patients lost were much higher than in care, most ART-related mortality occurred on treatment.