[Infectious Disease Reports 2014; 6:5167] [page 13] Mortality and loss to follow upbefore initiation of antiretrovi-ral therapy among HIV-infectedchildren eligible for HIV treatment

Data on attrition due to mortality or loss to follow-up (LTFU) from antiretroviral therapy (ART) eligibility to ART initiation of HIV-infected children are scarce. The aim of this study is to describe attrition before ART initia-tion of 247 children who were eligible for ART in a cohort study in India. Multivariable analy-sis was performed using competing risk regression. The cumulative incidence of attri-tion was 12.6 % (95 % confidence interval, 8.7-17.3) after five years of follow-up, and the attri-tion rate was higher during the first months after ART eligibility. Older children (>9 years) had a lower mortality risk before ART initiation than those aged <2 years. Female children had a lower risk of LTFU before ART initiation than males. Children who belonged to scheduled tribes had a higher risk of delayed ART initia-tion and LTFU. Orphan children had a higher risk of delayed ART initiation and mortality. Children who were>3 months in care before ART eligibility were less likely to be LTFU. The 12-month risk of AIDS, which was calculated using the absolute CD4 cell count and age, was strongly associated with mortality. A substan-tial proportion of ART-eligible children died or were LTFU before the initiation of ART. These findings can be used in HIV programmes to design actions aimed at reducing the attrition of ART-eligible children in India