Loss to follow-up among people living with HIV on tuberculosis preventive treatment at four regional referral hospitals, Uganda, 2019–2021

•Persons starting on ART and young adults had higher odds of being lost to follow-up.•Close follow-up of PLHIV aged 20–29 years could improve TPT completion.•Close follow-up of PLHIV newly initiated on ART could improve TPT completion.•Provision of shorter WHO-recommended TPT regimens could improve TPT completion. Tuberculosis (TB) remains the leading cause of death among people living with HIV (PLHIV). TB preventive treatment (TPT) can prevent active TB infection in PLHIV for several years after it is completed. During 2019–2021, the six-month course of TPT (using isoniazid) was the most readily available in Uganda; however, program data indicated a TPT program loss to follow-up (LTFU) rate of 12 % during this period. We evaluated factors associated with TPT LTFU among PLHIV in four regional referral hospitals (RRHs) in Uganda from 2019 to 2021. We abstracted program data from TPT registers on patient LTFU at Masaka, Mbale, Mubende, and Jinja RRHs. Additional data collected included client demographics, duration on HIV antiretroviral therapy (ART), year of TPT initiation, adherence, and point of entry. LTFU was defined as the failure to finish six consecutive months of isoniazid without stopping for more than two months at a time. We conducted bivariate analysis using the chi-square test for independence. Variables with p 95 %. Independent factors associated with LTFU included being on ART for