Do increasing rates of loss to follow-up in antiretroviral treatment programs imply deteriorating patient retention?

ABSTRACT: In several studies of antiretroviral treatment (ART) programs for persons with human immunodeficiency virus infection, investigators have reported that there has been a higher rate of loss to follow-up (LTFU) among patients initiating ART in recent years than among patients who initiated ART during earlier time periods. This finding is frequently interpreted as reflecting deterioration of patient retention in the face of increasing patient loads. However, in this paper we demonstrate by simulation that transient gaps in follow-up could lead to bias when standard survival analysis techniques are applied. We created a simulated cohort of patients with different dates of ART initiation. Rates of ART interruption, ART resumption, and mortality were assumed to remain constant over time, but whe

SUBMITTER: Johnson LF 

PROVIDER: S-EPMC4262442 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature