Unadjusted and adjusted estimates of attrition (death and LTF) at 1 year and ever after ART initiation among 9451 patients who initiated ART between January 2008 and December 2013 at the Themba Lethu Clinic in Johannesburg, South Africa
| Characteristic | 1-year after ART initiation | Ever after ART initiation | ||||
|---|---|---|---|---|---|---|
| Dead or LTF/N (%) | Unadjusted HR (95% CI) | Adjusted HR (95% CI) | Dead or LTF/N (%) | Unadjusted HR (95% CI) | Adjusted HR (95% CI) | |
| Citizenship status | ||||||
| Confirmed South African citizen | 1019/6822 (14.9%) | Reference | Reference | 1967/6822 (28.8%) | Reference | Reference |
| Unconfirmed South African citizen | 605/1616 (37.4%) | 2.94 (2.66 to 3.25) | 2.68 (2.42 to 2.97) | 959/1616 (59.3%) | 2.92 (2.70 to 3.15) | 2.68 (2.47 to 2.90) |
| Foreign national | 138/1013 (13.6%) | 0.89 (0.74 to 1.06) | 0.95 (0.79 to 1.14) | 254/1013 (25.1%) | 0.85 (0.75 to 0.97) | 0.88 (0.77 to 1.00) |
| Year of ART initiation | ||||||
| 2008–2009 | 754/3669 (20.6%) | Reference | Reference | 1505/3669 (41.0%) | Reference | Reference |
| 2010–2011 | 659/3744 (17.6%) | 0.85 (0.77 to 0.94) | 1.04 (0.90 to 1.19) | 1209/3744 (32.3%) | 0.84 (0.78 to 0.91) | 1.03 (0.92 to 1.14) |
| 2012–2013 | 349/2038 (17.1%) | 0.81 (0.71 to 0.92) | 1.22 (1.03 to 1.44) | 466/2038 (22.9%) | 0.71 (0.64 to 0.79) | 1.01 (0.88 to 1.15) |
| Sex | ||||||
| Male | 868/3779 (23.0%) | 1.52 (1.39 to 1.67) | 1.49 (1.34 to 1.65) | 1525/3779 (40.4%) | 1.51 (1.41 to 1.62) | 1.52 (1.41 to 1.64) |
| Female | 894/5672 (15.8%) | Reference | Reference | 1655/5672 (29.2%) | Reference | Reference |
| Age at ART initiation | ||||||
| <30 | 360/1689 (21.3%) | 1.18 (1.02 to 1.36) | 1.04 (0.90 to 1.21) | 673/1689 (39.9%) | 1.34 (1.21 to 1.49) | 1.22 (1.10 to 1.37) |
| 30–34.9 | 343/1957 (17.5%) | 0.95 (0.83 to 1.10) | 0.84 (0.72 to 0.97) | 696/1957 (35.6%) | 1.14 (1.03 to 1.27) | 1.06 (0.95 to 1.18) |
| 35–39.9 | 366/2034 (18.0%) | 0.98 (0.85 to 1.13) | 0.89 (0.77 to 1.03) | 642/2034 (31.6%) | 0.99 (0.89 to 1.10) | 0.93 (0.83 to 1.03) |
| 40–44.9 | 290/1541 (18.8%) | 1.04 (0.89 to 1.20) | 0.99 (0.85 to 1.15) | 482/1541 (31.3%) | 1.00 (0.89 to 1.12) | 0.97 (0.86 to 1.09) |
| ≥45 | 403/2230 (18.1%) | Reference | Reference | 687/2230 (30.8%) | Reference | Reference |
| Employment status | ||||||
| Employed | 892/5489 (16.3%) | Reference | Reference | 1605/5489 (29.2%) | Reference | Reference |
| Unemployed | 870/3962 (22.0%) | 1.41 (1.28 to 1.54) | 1.23 (1.11 to 1.35) | 1575/3962 (39.8%) | 1.46 (1.36 to 1.57) | 1.32 (1.23 to 1.42) |
| Baseline CD4 count (cells/mm3) | ||||||
| <50 | 675/2374 (28.4%) | 2.79 (2.42 to 3.22) | 1.93 (1.65 to 2.25) | 1048/2374 (44.1%) | 2.11 (1.90 to 2.35) | 1.56 (1.39 to 1.75) |
| 50–99 | 325/1618 (20.1%) | 1.84 (1.56 to 2.17) | 1.40 (1.18 to 1.67) | 573/1618 (35.4%) | 1.56 (1.38 to 1.75) | 1.24 (1.10 to 1.41) |
| 100–199 | 504/3264 (15.4%) | 1.36 (1.17 to 1.58) | 1.22 (1.04 to 1.42) | 1042/3264 (31.9%) | 1.35 (1.21 to 1.50) | 1.22 (1.10 to 1.36) |
| ≥200 | 258/2195 (11.8%) | Reference | Reference | 517/2195 (23.6%) | Reference | Reference |
| BMI at ART initiation (kg/m2) | ||||||
| <18.5 | 534/1754 (30.4%) | 1.87 (1.68 to 2.08) | 1.37 (1.22 to 1.53) | 836/1754 (47.7%) | 1.65 (1.52 to 1.79) | 1.30 (1.19 to 1.41) |
| 18.5–24.9 | 948/5220 (18.2%) | Reference | Reference | 1773/5220 (34.0%) | Reference | Reference |
| 25–29.9 | 194/1637 (11.9%) | 0.63 (0.54 to 0.73) | 0.83 (0.71 to 0.98) | 392/1637 (24.0%) | 0.66 (0.60 to 0.74) | 0.85 (0.76 to 0.96) |
| ≥30 | 86/840 (10.2%) | 0.54 (0.43 to 0.67) | 0.80 (0.64 to 1.01) | 179/840 (21.3%) | 0.58 (0.50 to 0.68) | 0.83 (0.71 to 0.97) |
| WHO stage | ||||||
| I/II | 817/5483 (14.9%) | Reference | Reference | 1564/5483 (28.5%) | Reference | Reference |
| III/IV | 945/3968 (23.8%) | 1.72 (1.57 to 1.89) | 1.13 (1.01 to 1.27) | 1616/3968 (40.7%) | 1.52 (1.42 to 1.63) | 1.10 (1.02 to 1.20) |
| Anaemia at ART initiation | ||||||
| No anaemia | 330/2606 (12.7%) | Reference | Reference | 713/2606 (27.4%) | Reference | Reference |
| Mild anaemia | 367/2326 (15.8%) | 1.27 (1.10 to 1.48) | 1.06 (0.91 to 1.24) | 725/2326 (31.2%) | 1.13 (1.02 to 1.26) | 0.99 (0.89 to 1.10) |
| Moderate anaemia | 810/3751 (21.6%) | 1.84 (1.62 to 2.09) | 1.46 (1.27 to 1.68) | 1382/3751 (36.8%) | 1.43 (1.30 to 1.56) | 1.21 (1.09 to 1.33) |
| Severe anaemia | 255/768 (33.2%) | 3.19 (2.71 to 3.76) | 2.23 (1.85 to 2.67) | 360/768 (46.9%) | 2.10 (1.85 to 2.38) | 1.61 (1.40 to 1.85) |
| Co-infected with tuberculosis at ART initiation | ||||||
| No | 1469/8297 (17.7%) | Reference | Reference | 2662/8297 (32.1%) | Reference | Reference |
| Yes | 293/1154 (25.4%) | 1.50 (1.33 to 1.70) | 0.92 (0.80 to 1.06) | 518/1154 (44.9%) | 1.48 (1.35 to 1.63) | 1.00 (0.90 to 1.11) |
| First ART regimen* | ||||||
| TDF-3TC-EFV | 688/3994 (17.2%) | Reference | Reference | 1171/3994 (29.3%) | Reference | Reference |
| d4T-3TC-EFV | 860/4132 (20.8%) | 1.24 (1.12 to 1.37) | 1.03 (0.90 to 1.19) | 1651/4132 (40.0%) | 1.27 (1.18 to 1.37) | 1.05 (0.95 to 1.17) |
| AZT-3TC-EFV | 40/182 (22.0%) | 1.33 (0.97 to 1.83) | 1.26 (0.90 to 1.74) | 62/182 (34.1%) | 1.20 (0.93 to 1.55) | 1.13 (0.86 to 1.46) |
| Other | 174/1143 (15.2%) | 0.87 (0.74 to 1.03) | 0.91 (0.76 to 1.09) | 296/1143 (25.9%) | 0.99 (0.87 to 1.12) | 1.02 (0.89 to 1.17) |
*3TC: lamivudine; AZT: zidovudine; d4T: stavudine; EFV: efavirenz; TDF: tenofovir; Other regimens are: TDF-3TC-NVP (nevirapine), AZT-3TC-NVP, TDF-EMT (emtricitabine)-EFV, TDF-EMT-NVP, and d4T-3TC-NVP.
ART, antiretroviral therapy; BMI, body mass index; LTF, loss to follow-up.