Verses from the Abstract

What follows are some exciting excerpts from the very first abstract to come out of the TB-HIV coinfection study I've been working on for the past 10 months. The finding described in the abstract - essentially, that there is a great deal of death and unexplained drop-out among patients poised to begin antiretroviral therapy (ART) in the clinic we've been working in - actually has little to do with TB in particular, although many of the mortalities described in the abstract were of HIV-positive patients thought to have active cases of TB.

This abstract has already been submitted for one of the big AIDS conference taking place in the United States in early 2008. Hopefully we'll be hearing back relatively soon if it was accepted or not!

I'm so not ready to leave this place just yet.

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Loss to Care and Death before ART: Patients Eligible for Treatment Who Do Not Make it in Durban, South Africa

Background: Early losses from care during antiretroviral therapy (ART) have been described for patients attending HIV or ART clinics in resource-limited settings. Our objective was to examine the loss to follow-up and mortality rates among ART-eligible patients who have not yet started therapy.

Methods: We performed a retrospective chart review for all HIV-infected adults who were eligible for ART training and treatment (CD4 ≤ 200/μl or clinical criteria) at an urban HIV clinic in Durban, South Africa from July-Dec. 2006. Patients who did not start ART and were lost to care prior to or within 3 months of the 1st of 3 ART training visits were phoned to ascertain their status.

Conclusions: Loss to follow-up and death occur frequently following first CD4 count but before starting ART in Durban, South Africa. Time from CD4 count to the initiation of ART training is months, even in those with the lowest CD4 counts. Interventions that improve linkage to care and prioritize ART initiation for those with low baseline CD4 counts are needed.

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As Q-Tip once famously said:

I'm movin, yes I'm groovin', becacuse my mouth is on the motor/
Use the Coast in the mornin' to avoid the funky odor/
Can't help bein' funky, I'm the funky Abstract brotha/

word.