Table 3.
Predictors of attrition at ten years of ART among patients who initiated ART between April 2004 and March 2007a
| Female (N = 4414) | Male (N = 2230) | |||||
|---|---|---|---|---|---|---|
| n/N (%) | Crude HR (95% CI) | Adjusted HR (95% CI) | n/N (%) | Crude HR (95% CI) | Adjusted HR (95% CI) | |
| ART initiation cohort | ||||||
| Year 1 | 514/1262 (40.7) | 1.00 | 1.00 | 264/562 (47.0) | 1.00 | 1.00 |
| Year 2 | 691/1471 (47.0) | 1.30 (1.16 to 1.46) | 1.26 (1.11 to 1.43) | 382/718 (53.2) | 1.20 (1.03 to 1.40) | 1.17 (0.98 to 1.38) |
| Year 3 | 802/1681 (47.7) | 1.40 (1.24 to 1.55) | 1.39 (1.24 to 1.57) | 485/950 (51.1) | 1.20 (1.03 to 1.40) | 1.23 (1.05 to 1.45) |
| Nationality | ||||||
| Non‐South African | 55/162 (34.0) | 1.00 | 1.00 | 42/117 (35.9) | 1.00 | 1.00 |
| South African | 1951/4250 (45.9) | 1.55 (1.18 to 2.02) | 1.57 (1.17 to 2.09) | 1089/2113 (51.5) | 1.76 (1.29 to 2.40) | 1.77 (1.26 to 2.47) |
| Missing | 1/2 (50.0) | |||||
| Age at ART initiation (years) | ||||||
| 1 8 to 24.9 | 198/349 (56.7) | 1.00 | 1.00 | 26/42 (61.9) | 1.00 | 1.00 |
| 25 to 29.9 | 451/896 (50.3) | 0.86 (0.73 to 1.02) | 0.90 (0.75 to 1.08) | 116/224 (51.8) | 0.90 (0.59 to 1.37) | 0.96 (0.60 to 1.52) |
| 30 to 39.9 | 853/2049 (41.6) | 0.67 (0.57 to 0.78) | 0.72 (0.61 to 0.85) | 540/1115 (48.4) | 0.83 (0.56 to 1.24) | 0.88 (0.58 to 1.36) |
| 40 to 49.9 | 363/852 (42.6) | 0.67 (0.56 to 0.79) | 0.74 (0.61 to 0.89) | 318/612 (52.0) | 0.89 (0.60 to 1.33) | 0.96 (0.62 to 1.48) |
| >50 | 142/268 (53.0) | 0.90 (0.73 to 1.12) | 1.07 (0.85 to 1.35) | 131/237 (55.3) | 0.96 (0.63 to 1.46) | 1.08 (0.69 to 1.71) |
| CD4 count at ART initiation (cells/mm3) | ||||||
| 0 to 100 | 1052/2229 (47.2) | 1.00 | 1.00 | 714/1355 (52.7) | 1.00 | 1.00 |
| 101 to 200 | 685/1569 (43.7) | 0.87 (0.79 to 0.95) | 0.90 (0.81 to 1.01) | 218/661 (48.1) | 0.87 (0.76 to 0.99) | 0.95 (0.83 to 1.10) |
| 201 to 350 | 212/491 (43.2) | 0.85 (0.74 to 0.99) | 0.88 (0.74 to 1.04) | 79/175 (44.9) | 0.81 (0.64 to 1.02) | 0.83 (0.64 to 1.07) |
| 351 to 500 | 24/77 (31.2) | 0.52 (0.35 to 0.78) | 0.53 (0.34 to 0.83) | 13/27 (48.2) | 0.89 (0.51 to 1.54) | 1.20 (0.65 to 2.20) |
| >500 | 11/24 (45.8) | 0.83 (0.46 to 1.51) | 0.96 (0.51 to 1.82) | 5/9 (55.6) | 1.23 (0.51 to 2.95) | 1.30 (0.54 to 3.16) |
| Missing | 23/24 (96.0) | 2/2 (100.0) | ||||
| WHO Stage at ART initiation | ||||||
| Stage 1/2 | 1104/2486 (44.4) | 1.00 | 1.00 | 496/1014 (48.9) | 1.00 | 1.00 |
| Stage 3/4 | 903/1928 (46.8) | 1.10 (1.00 to 1.20) | 0.94 (0.84 to 1.06) | 635/1216 (52.2) | 1.11 (0.99 to 1.25) | 1.09 (0.94 to 1.26) |
| Anaemia at ART initiationb | ||||||
| None | 594/1513 (39.3) | 1.00 | 1.00 | 397/880 (45.1) | 1.00 | 1.00 |
| Mild | 335/839 (39.9) | 1.01 (0.88 to 1.16) | 1.02 (0.88 to 1.17) | 328/656 (50.0) | 1.17 (1.01 to 1.36) | 1.12 (0.96 to 1.31) |
| Moderate | 829/1682 (49.3) | 1.40 (1.26 to 1.55) | 1.32 (1.17 to 1.48) | 320/576 (55.6) | 1.40 (1.21 to 1.63) | 1.31 (1.11 to 1.55) |
| Severe | 182/307 (59.3) | 1.94 (1.64 to 2.29) | 1.83 (1.51 to 2.22) | 80/112 (71.4) | 2.19 (1.72 to 2.78) | 2.06 (1.57 to 2.69) |
| Missing | 67/73 (91.8) | 6/6 (100.0) | ||||
| BMI at ART initiationc | ||||||
| Underweight | 347/645 (53.8) | 1.44 (1.27 to 1.63) | 1.33 (1.17 to 1.51) | 313/556 (56.3) | 1.28 (1.12 to 1.47) | 1.15 (1.00 to 1.32) |
| Normal | 903/2101 (43.0) | 1.00 | 1.00 | 634/1322 (48.0) | 1.00 | 1.00 |
| Overweight | 369/895 (41.2) | 0.97 (0.86 to 1.10) | 0.95 (0.83 to 1.08) | 73/176 (41.5) | 0.81 (0.64 to 1.04) | 0.86 (0.67 to 1.10) |
| Obese | 191/444 (43.0) | 1.02 (0.87 to 1.19) | 1.05 (0.89 to 1.25) | 13/29 (44.8) | 0.82 (0.47 to 1.42) | 0.80 (0.46 to 1.39) |
| Missing | 197/329 (60.0) | 98/147 (66.7) | ||||
| TB at ART initiation | ||||||
| No | 1680/3741 (44.9) | 1.00 | 1.00 | 888/1726 (51.5) | 1.00 | 1.00 |
| Yes | 327/673 (48.6) | 1.11 (0.99 to 1.25) | 0.99 (0.86 to 1.15) | 243/504 (48.2) | 0.88 (0.76 to 1.01) | 0.76 (0.64 to 0.90) |
| Baseline ART regimen | ||||||
| NRTI | ||||||
| Stavudine | 1952/4308 (45.3) | 1.00 | 1.00 | 1088/2152 (50.6) | 1.00 | 1.00 |
| Zidovudine | 55/106 (51.9) | 1.33 (1.02 to 1.74) | 1.37 (1.01 to 1.87) | 43/78 (55.1) | 1.21 (0.89 to 1.65) | 1.28 (0.92 to 1.78) |
| PI | ||||||
| No | 1699/3844 (44.2) | 1.00 | 1.00 | 1126/2209 (51.0) | 1.00 | 1.00 |
| Yes | 308/570 (54.0) | 1.36 (1.21 to 1.54) | 1.30 (1.11 to 1.51) | 5/21 (23.8) | 0.36 (0.15 to 0.87) | 0.34 (0.11 to 1.05) |
CI, confidence interval; HR hazard ratio, PI, protease inhibitor.
Hazard ratio estimated from a Cox proportional hazard model.
a
Attrition: loss to follow‐up and death.
b
Anaemia is defined as: none if haemoglobin ≥12 for females and ≥13 for males; mild if haemoglobin 11.0 to 11.9 for females and 11.0 to 12.9 for males; moderate if haemoglobin between 8.0 and 10.9 for females and males; and severe if haemoglobin <8.0 for females and males (according to WHO guidelines).
c
BMI categories are defined as: underweight if calculated BMI is <18.5 (kg/m2); normal if BMI is between 18.5 and 24.9 kg/m2; overweight if BMI is between 25.0 and 29.9 kg/m2 and obese if BMI is ≥30.0 kg/m2.