Trends in Follow-Up Visits Among People Living With HIV: Results From the TREAT Asia and Australian HIV Observational Databases
Less frequent follow-up visits may reduce the burden on people living with HIV (PLHIV) and health care facilities. We aimed to assess trends in follow-up visits and survival outcomes among PLHIV in Asia and Australasia. PLHIV enrolled in TREAT Asia HIV Observational Database (TAHOD) or Australian HI...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2021-09, Vol.88 (1), p.70-78 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Jiamsakul, Awachana Boyd, Mark Choi, Jun Yong Edmiston, Natalie Kumarasamy, Nagalingeswaran Hutchinson, Jolie Law, Matthew Ditangco, Rossana |
| description | Less frequent follow-up visits may reduce the burden on people living with HIV (PLHIV) and health care facilities. We aimed to assess trends in follow-up visits and survival outcomes among PLHIV in Asia and Australasia.
PLHIV enrolled in TREAT Asia HIV Observational Database (TAHOD) or Australian HIV Observational Database (AHOD) from 2008 to 2017 were included.
Follow-up visits included laboratory testing and clinic visit dates. Visit rates and survival were analyzed using repeated measure Poisson regression and competing risk regression, respectively. Additional analyses were limited to stable PLHIV with viral load |
| doi_str_mv | 10.1097/QAI.0000000000002725 |
| format | Article |
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PLHIV enrolled in TREAT Asia HIV Observational Database (TAHOD) or Australian HIV Observational Database (AHOD) from 2008 to 2017 were included.
Follow-up visits included laboratory testing and clinic visit dates. Visit rates and survival were analyzed using repeated measure Poisson regression and competing risk regression, respectively. Additional analyses were limited to stable PLHIV with viral load <1000 copies/mL and self-reported adherence ≥95%.
We included 7707 PLHIV from TAHOD and 3289 PLHIV from AHOD. Visit rates were 4.33 per person-years (/PYS) in TAHOD and 3.68/PYS in AHOD. Both TAHOD and AHOD showed decreasing visit rates in later calendar years compared with that in years 2008-2009 (P < 0.001 for both cohorts). Compared with PLHIV with 2 visits, those with ≥4 visits had poorer survival: TAHOD ≥4 visits, subhazard ratio (SHR) = 1.88, 95% confidence interval (CI): 1.16 to 3.03, P = 0.010; AHOD ≥4 visits, SHR = 1.80, 95% CI: 1.10 to 2.97, P = 0.020; whereas those with ≤1 visit showed no differences in mortality. The association remained evident among stable PLHIV: TAHOD ≥4 visits, SHR = 5.79, 95% CI: 1.84 to 18.24, P = 0.003; AHOD ≥4 visits, SHR = 2.15, 95% CI: 1.20 to 3.85, P = 0.010, compared with 2 visits.
Both TAHOD and AHOD visit rates have declined. Less frequent visits did not affect survival outcomes; however, poorer health possibly leads to increased follow-up and higher mortality. Reducing visit frequency may be achievable among PLHIV with no other medical complications.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000002725</identifier><identifier>PMID: 33990493</identifier><language>eng</language><publisher>United States: JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher><subject>Adult ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Asia - epidemiology ; Australia - epidemiology ; Complications ; Confidence intervals ; Female ; Follow-Up Studies ; Health care ; Health care facilities ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - mortality ; Human immunodeficiency virus ; Humans ; Kaplan-Meier Estimate ; Laboratory tests ; Male ; Medication Adherence ; Middle Aged ; Mortality ; Statistical analysis ; Survival ; Trends ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2021-09, Vol.88 (1), p.70-78</ispartof><rights>JAIDS Journal of Acquired Immune Deficiency Syndromes</rights><rights>Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4300-8aff0f5a6c70fff42ee36e2370a69e5a96d513c802c256743c7c51d9491349d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00126334-202109010-00010$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-202109010-00010$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>230,314,780,784,885,4609,27924,27925,64666,65461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33990493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiamsakul, Awachana</creatorcontrib><creatorcontrib>Boyd, Mark</creatorcontrib><creatorcontrib>Choi, Jun Yong</creatorcontrib><creatorcontrib>Edmiston, Natalie</creatorcontrib><creatorcontrib>Kumarasamy, Nagalingeswaran</creatorcontrib><creatorcontrib>Hutchinson, Jolie</creatorcontrib><creatorcontrib>Law, Matthew</creatorcontrib><creatorcontrib>Ditangco, Rossana</creatorcontrib><creatorcontrib>TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD) of IeDEA Asia-Pacific</creatorcontrib><creatorcontrib>on behalf of the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD) of IeDEA Asia-Pacific</creatorcontrib><title>Trends in Follow-Up Visits Among People Living With HIV: Results From the TREAT Asia and Australian HIV Observational Databases</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>Less frequent follow-up visits may reduce the burden on people living with HIV (PLHIV) and health care facilities. We aimed to assess trends in follow-up visits and survival outcomes among PLHIV in Asia and Australasia.
PLHIV enrolled in TREAT Asia HIV Observational Database (TAHOD) or Australian HIV Observational Database (AHOD) from 2008 to 2017 were included.
Follow-up visits included laboratory testing and clinic visit dates. Visit rates and survival were analyzed using repeated measure Poisson regression and competing risk regression, respectively. Additional analyses were limited to stable PLHIV with viral load <1000 copies/mL and self-reported adherence ≥95%.
We included 7707 PLHIV from TAHOD and 3289 PLHIV from AHOD. Visit rates were 4.33 per person-years (/PYS) in TAHOD and 3.68/PYS in AHOD. Both TAHOD and AHOD showed decreasing visit rates in later calendar years compared with that in years 2008-2009 (P < 0.001 for both cohorts). Compared with PLHIV with 2 visits, those with ≥4 visits had poorer survival: TAHOD ≥4 visits, subhazard ratio (SHR) = 1.88, 95% confidence interval (CI): 1.16 to 3.03, P = 0.010; AHOD ≥4 visits, SHR = 1.80, 95% CI: 1.10 to 2.97, P = 0.020; whereas those with ≤1 visit showed no differences in mortality. The association remained evident among stable PLHIV: TAHOD ≥4 visits, SHR = 5.79, 95% CI: 1.84 to 18.24, P = 0.003; AHOD ≥4 visits, SHR = 2.15, 95% CI: 1.20 to 3.85, P = 0.010, compared with 2 visits.
Both TAHOD and AHOD visit rates have declined. Less frequent visits did not affect survival outcomes; however, poorer health possibly leads to increased follow-up and higher mortality. Reducing visit frequency may be achievable among PLHIV with no other medical complications.</description><subject>Adult</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Asia - epidemiology</subject><subject>Australia - epidemiology</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - mortality</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Laboratory tests</subject><subject>Male</subject><subject>Medication Adherence</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Statistical analysis</subject><subject>Survival</subject><subject>Trends</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9v1DAQxSMEoqXwDRCyxIVLiv875oAUlS5daaVCtS1Hy5tMGhdvvLWTXXHiq-NVSyn1ZWzNm5_f6BXFW4KPCdbq4_d6fowfHaqoeFYcEs15qaqKP893QUXJCRMHxauUbjAmknP9sjhgTGvMNTssfi8jDG1CbkCz4H3YlZcbdOWSGxOq12G4Rt8gbDyghdu6_Prhxh6dza8-oQtIk8-qWQxrNPaAlhen9RLVyVlkhxbVUxqj9c4Oez06XyWIWzu6MFiPvtjRrmyC9Lp40Vmf4M19PSouZ6fLk7Nycf51flIvyoYzjMvKdh3uhJWNwl3XcQrAJFCmsJUahNWyFYQ1FaYNFVJx1qhGkFZzTRjXLWdHxec77mZaraFtYNibM5vo1jb-MsE6839ncL25DltTMcWkkBnw4R4Qw-0EaTRrlxrw3g4QpmSooBVRUgmcpe-fSG_CFPPaWSWlFhRTvXfE71RNDClF6B7MEGz2CZucsHmacB5793iRh6G_kf7j7oIfIaafftpBND1YP_aZR6hkjJfZRP4EE1xmMsHsD1dhr-8</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Jiamsakul, Awachana</creator><creator>Boyd, Mark</creator><creator>Choi, Jun Yong</creator><creator>Edmiston, Natalie</creator><creator>Kumarasamy, Nagalingeswaran</creator><creator>Hutchinson, Jolie</creator><creator>Law, Matthew</creator><creator>Ditangco, Rossana</creator><general>JAIDS Journal of Acquired Immune Deficiency Syndromes</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210901</creationdate><title>Trends in Follow-Up Visits Among People Living With HIV: Results From the TREAT Asia and Australian HIV Observational Databases</title><author>Jiamsakul, Awachana ; 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We aimed to assess trends in follow-up visits and survival outcomes among PLHIV in Asia and Australasia.
PLHIV enrolled in TREAT Asia HIV Observational Database (TAHOD) or Australian HIV Observational Database (AHOD) from 2008 to 2017 were included.
Follow-up visits included laboratory testing and clinic visit dates. Visit rates and survival were analyzed using repeated measure Poisson regression and competing risk regression, respectively. Additional analyses were limited to stable PLHIV with viral load <1000 copies/mL and self-reported adherence ≥95%.
We included 7707 PLHIV from TAHOD and 3289 PLHIV from AHOD. Visit rates were 4.33 per person-years (/PYS) in TAHOD and 3.68/PYS in AHOD. Both TAHOD and AHOD showed decreasing visit rates in later calendar years compared with that in years 2008-2009 (P < 0.001 for both cohorts). Compared with PLHIV with 2 visits, those with ≥4 visits had poorer survival: TAHOD ≥4 visits, subhazard ratio (SHR) = 1.88, 95% confidence interval (CI): 1.16 to 3.03, P = 0.010; AHOD ≥4 visits, SHR = 1.80, 95% CI: 1.10 to 2.97, P = 0.020; whereas those with ≤1 visit showed no differences in mortality. The association remained evident among stable PLHIV: TAHOD ≥4 visits, SHR = 5.79, 95% CI: 1.84 to 18.24, P = 0.003; AHOD ≥4 visits, SHR = 2.15, 95% CI: 1.20 to 3.85, P = 0.010, compared with 2 visits.
Both TAHOD and AHOD visit rates have declined. Less frequent visits did not affect survival outcomes; however, poorer health possibly leads to increased follow-up and higher mortality. Reducing visit frequency may be achievable among PLHIV with no other medical complications.</abstract><cop>United States</cop><pub>JAIDS Journal of Acquired Immune Deficiency Syndromes</pub><pmid>33990493</pmid><doi>10.1097/QAI.0000000000002725</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2021-09, Vol.88 (1), p.70-78 |
| issn | 1525-4135 1944-7884 |
| language | eng |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Free E- Journals |
| subjects | Adult Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active Asia - epidemiology Australia - epidemiology Complications Confidence intervals Female Follow-Up Studies Health care Health care facilities HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - mortality Human immunodeficiency virus Humans Kaplan-Meier Estimate Laboratory tests Male Medication Adherence Middle Aged Mortality Statistical analysis Survival Trends Young Adult |
| title | Trends in Follow-Up Visits Among People Living With HIV: Results From the TREAT Asia and Australian HIV Observational Databases |
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