Long-term outcomes of psychiatric patients initiated on Anti-Retroviral Therapy (ART) at Luthando Clinic in 2008-2010
Date
2018
Authors
Mdaka, Nokuthula Audrey
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Abstract
The Luthando Neuropsychiatric Clinic (Luthando Clinic) is a HIV and neuropsychiatry unit situated at the Chris Hani Baragwanath Academic Hospital (CHBAH) located at the South-Western Township of Johannesburg (SOWETO). The centre provides care for psychiatric patients who are also diagnosed with HIV, using a multidisciplinary integrated model of care. (1) Previous research at the Luthando Clinic has focused on short-term treatment outcomes.(1,2) The aim of this study was to determine the longterm (four-year) outcomes of psychiatric patients initiated on ART between 1 June 2008 and 31 December 2010 at the Luthando Clinic.
METHODS : A retrospective record review using patient files was conducted to examine follow-up and clinical outcomes. The primary outcome of the study was to determine follow-up outcomes (retained in care, loss to follow up, transferred to other centres, those who died) four years after initiation of ART. Retention in care was further explored as a secondary outcome. Clinical data of the patients who were retained in integrated care at four years after ART initiation were then collected and compared to baseline data (at ART initiation) to determine clinical outcomes.
RESULTS: Of the 291 patients initiated on ART at the clinic, 49.8% remained in integrated care at the end of the four-year follow-up period, 24.1% were lost to follow-up, 19.9% were transferred to other treatment centres and 6.2% had died. For those who remained in integrated care, there was a statistically significant increase in the CD4 count from baseline to the fouryear follow-up period of 350 cells/mm3 (p<0.0001), and 71.8% (p<0.0001) of the patients had suppressed viral load values at the end of the four-year follow-up period.
Description
A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg in partial fulfilment for the degree of MMed Psychiatry. Johannesburg 2018