Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa, 2007-2009: systematic review.

摘要: Summary objectives To estimate the proportion of all-cause adult patient attrition from antiretroviral therapy (ART) programs in service delivery settings sub-Saharan Africa through 36 months on treatment. methods We identified cohorts within Ovid Medline, ISI Web Knowledge, Cochrane Database Systematic Reviews and four conference abstract archives. summarized retention rates studies describing observational reporting HIV 1- infected patients initiating first-line three-drug ART. estimated for 6, 12, 18, 24, or after ART initiation including who died were lost to follow-up (as defined by author), but excluding transferred patients. results analysed 33 sources 39 226 307 Patients more likely be female (median 65%) had a median age at 37 (range 34‐40). Median starting CD4 count was 109 cells ⁄mm 3 . Loss most common cause (59%), followed death (41%). 24 22.6% 7%‐45%), 25% 11%‐32%) 29.5% 13%‐36.1%) respectively. After pooling data random-effects metaanalysis, declined 86.1% 6 80.2% 12 months, 76.8% 72.3% months. Adjusting variable time sensitivity analysis, month 70.0% (range: 66.7%‐73.3%), while 64.6% 57.5%‐72.1%). conclusions Our findings document difficulties retaining care lifelong treatment, progress being made raising overall rates.