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Factors associated with loss to follow-up after occupational HIV exposure in Cape Town, South Africa: a retrospective cohort study

BACKGROUND: There is limited data on factors associated with loss to follow-up (LTFU) of health care workers (HCWs) following occupational exposure to HIV, and most studies were conducted in an era when poorly tolerated antiretrovirals like zidovudine were used. METHODS: A retrospective cohort study...

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Detalles Bibliográficos
Autores principales: Papavarnavas, Nectarios Sophocles, Manning, Kathryn, Conrad, Fahd, Govender, Milah, Maartens, Gary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401471/
https://www.ncbi.nlm.nih.gov/pubmed/28431556
http://dx.doi.org/10.1186/s12981-017-0149-8
Descripción
Sumario:BACKGROUND: There is limited data on factors associated with loss to follow-up (LTFU) of health care workers (HCWs) following occupational exposure to HIV, and most studies were conducted in an era when poorly tolerated antiretrovirals like zidovudine were used. METHODS: A retrospective cohort study was conducted of HCWs attending a referral hospital’s Occupational Health Clinic in Cape Town, South Africa for post-exposure prophylaxis (PEP) during a period when tenofovir was available. Our primary outcome was LTFU at the 3-month visit. We selected seven variables a priori for our logistic regression model and ensured there were at least 10 outcome events per variable to minimize bias. RESULTS: Two hundred and ninety-three folders were evaluated for descriptive analysis. LTFU worsened with successive visits: 36% at 6 weeks, 60% at 3 months, and 72% at 6 months. In multivariate analysis at the 3-month visit LTFU was associated with age (adjusted odds ratio (aOR), 0.6 per 10-year increase [95% CI, 0.5–0.9]), HCW category of doctor (aOR 2.7 [95% CI, 1.3–5.5]), and time from exposure to receiving PEP of more than 24 h (aOR 5.9 [95% CI, 1.3–26.9]). CONCLUSION: We identified factors associated with LTFU of HCWs after occupational HIV exposure, which could be used to target interventions to improve follow-up.