The objective was to determine the proportion, characteristics and
outcomes of patients who transfer-out from an antiretroviral therapy
(ART) service in a South African township.
This retrospective cohort study included all patients aged ≥15 years who
enrolled between September 2002 and December 2009. Follow-up data were
censored in December 2010. Kaplan-Meier survival analysis was used to
describe time to transfer-out and cox proportional hazard analysis was
used to determine associated risk factors.
4511 patients (4003 ART-naive and 508 non-naive at baseline) received
ART during the study period. Overall, 597 (13.2%) transferred out. The
probability of transferring out by one year of ART steadily increased
from 1.4% in 2002/2004 cohort to 8.9% for the 2009 cohort. Independent
risk factors for transfer-out were more recent calendar year of
enrolment, younger age (≤25 years) and being ART non-naive at baseline
(i.e., having previously transferred into this clinic from another
facility). The proportions of patients transferred out who had a CD4
The study concluded that with scale-up of ART over time, an increasing
proportion of patients are transferring between ART services and
information systems are needed to track patients. Approximately
one-fifth of these have viral loads >1000 copies/mL around the time
of transfer, suggesting the need for careful adherence counseling and
assessment of medication supplies among those planning transfer.
Nglazi, MD.; Kaplan, R.; Orrell, C.; Myer, L.; Wood, R.; Bekker, LG.; Lawn, SD. Increasing Transfers-Out from an Antiretroviral Treatment Service in South Africa: Patient Characteristics and Rates of Virological Non-Suppression. PLoS ONE (2013) 8 (3) e57907. [DOI: 10.1371/journal.pone.0057907]
Increasing Transfers-Out from an Antiretroviral Treatment Service in South Africa: Patient Characteristics and Rates of Virological Non-Suppression.