Abstract

Loss to follow-up (LTFU) and mortality after initiating antiretroviral therapy (ART) remain major problem. We described predictive factors of LTFU and mortality after initiating ART among people living with HIV (PLHIV) and were followed in the district hospital of Boromo. This was a retrospective cohort study design of PLHIV enrolled for care and treatment in the district hospital of Boromo between 1 January 2015 and 31 December 2019. Eligibility was based on being 15 years and above. A competing risk analysis was used to identify LTFU and mortality predictive factors. Five hundred and fifty (550) PLHIV were included in this study. They were female in the majority (80.55%) and had a median age of 34 years [interquartile range (IQR): 26-43]. The median follow-up time was 1.28 years (IQR: 0.47-2.87). The incidence rate of LTFU was 220 (95% CI: 191.8-252.4) per 1000 person-years (PY). The predictive factors of LTFU were young age (age<45 years) [adjusted sub-hazard ratio (aSHR)=1.79; 95% CI: 1.19-2.68; p=0.0011] and HIV2 infection (aSHR =2.15; 95% CI: 1.26-3.67; p=0.0011). The mortality incidence rate was 34.5 (95% CI: 24.4-48.8) per 1000 person-years. The predictors of mortality were advanced disease stage based on WHO classification (aSHR=2.76; 95% CI: 1.25-6.09; p=0.0115) and lack of cotrimoxazole prophylaxis (aSHR=2.65; 95% CI: 1.17-5.97; p=0.0185). The incidence rates of LTFU and mortality after initiating ART were high. Strengthening therapeutic education and outreach by community health workers focusing PLHIV who are more at risk would lead to better ART outcomes.

Key words: HIV, antiretroviral therapy, loss to follow-up, mortality, Boromo, Burkina Faso.