Continuum of care among HIV-1 positive patients in a single center in Italy (2007–2017)

Figures & data

Table 1 Baseline characteristics and retention in care at the EFU (N=423)

Characteristics
Age (years), median (IQR)	46 (55–38)
Male sex, n (%)	346 (81.0)
FU (months), median (IQR)	64 (98–41)
Origin, n (%)
• Italy	309 (73.0)
• Europe (not Italy)	8 (1.9)
• East Europe	28 (6.6)
• Middle East	5 (1.2)
• Asia	7 (1.6)
• Latin America	28 (6.6)
• Africa	38 (9.0)
Risk factor, n (%)
• Heterosexual	162 (38.3)
• MSM	214 (50.6)
• IVDU	18 (4.3)
• Transfusion	3 (0.7)
• Unknown	26 (6.1)
HCV Ab positive, n (%)	37 (9.2)
HBsAg positive, n (%)	21 (5.1)
AIDS, n (%)	78 (18.5)
Acute infection, n (%)	36 (8.5)
Nadir CD4 (cells/μL), median (IQR)	310 (452–112)
Zenith (log10), median (IQR)	5.1 (5.5–4.5)
Status at the EFU
• Retained in care, n (%)	311 (73.5)
• Moved to another center, n (%)	25 (5.9)
• LTFU, n (%)	64 (15.1)
• Death, n (%)	23 (5.5)

Abbreviations: EFU, end of the follow-up; FU, follow-up; HBsAg, hepatitis B surface antigen; HCV Ab, hepatitis C virus antibodies; MSM, men who have sex with men; IVDU, intravenous drug user; LTFU, lost to follow-up.

Figure 1 The cascade of continuum of care at AOUC, Florence, Italy.

Abbreviations: AOUC, Azienda Ospedaliero – Universitaria Careggi; ART, antiretroviral treatment.

Figure 2 Kaplan–Meier plot: retention in care by nationality during a 10-year FU at AOUC, Florence, Italy.

Abbreviations: FU, follow-up; AOUC, Azienda Ospedaliero – Universitaria Careggi.

Figure 3 Kaplan–Meier plot: retention in care by age at HIV diagnosis during a 10-year FU at AOUC, Florence, Italy.

Abbreviations: FU, follow-up; AOUC, Azienda Ospedaliero – Universitaria Careggi.

Table 2 Factors associated with loss to FU

Characteristics and categorya	LTFU incidence rateb	Crude RR	95% CI	P-value	Multivariatec (HR)	95% CI	P-value
Age at entry
• >50	17.6	1	ref	–
• 36–50	29.0	1.65	0.88–3.11	0.1183	0.98	0.48–2.03	0.97
• <35	66.7	3.80	1.90–7.58	<0.0001	1.85	1.04–3.30	0.037
Gender
• Female	38.9	1	ref	–
• Male	27.7	0.71	0.40–1.27	0.2494	–	–	–
Origin
• Italian	20.2	1	ref
• Not Italian	58.0	2.86	1.75–4.70	<0.0001	1.69	0.99–2.89	0.054
Risk
• Not MSM	34.7	1	ref
• MSM	24.5	0.68	0.41–1.13	0.237	–	–	–
Therapy at the EFU
• On ART	17.5	1	ref
• Off ART	249.1	14.25	8.67–23.40	<0.001	10.33	5.80–18.40	<0.001
HCV Ab at entry
• Negative	31.8
• Positive	21.4	0.67	0.24–1.86	0.4382	–	–	–
HBsAg at entry
• Negative	29.4	1	ref
• Postive	24.5	0.83	0.26–267	0.7579	–	–	–
STR at the EFU
• No	21.8	1
• Yes	13.1	0.60	0.30–1.19	0.2424	–	–	–
Previous AIDS event
• No	31.3	1	ref
• Yes	18.4	0.59	0.25–1.36	0.2096	–	–	–
Acute infection
• No	31.3	1	ref
• Yes	11.8	0.38	0.09–1.55	0.1596	–	–	–
Nadir CD4 (cells/μL)
• >500	49.2	1	ref	–
• 200–500	27.3	0.55	0.30–1.03	0.0579	1.61	0.80–3.24	0.177
• <200	25.1	0.51	0.25–1.00	0.0480	1.73	0.72–4.12	0.214
Zenith
HIV-RNA (copies/mL)
• Low <100,000	41.5	1	ref
• High >100,000	18.6	0.49	0.26–0.77	0.0027	0.74	0.40–1.36	0.338

Notes:

a n=375.

b Per 1,000 person-years.

c Adjusted for age at entry, origin, nadir, zenith viremia, and therapy at the EFU.

Abbreviations: FU, follow-up; LTFU, lost to follow-up; RR, risk ratio; ref, reference; MSM, men who have sex with men; EFU, end of the follow-up; ART, antiretroviral treatment; VL, viral load; STR, single tablet regimen.