BRIEF REPORT: EPIDEMIOLOGY AND PREVENTION Does Most Mortality in Patients on ART Occur in Care or After Lost to Follow-Up? Evidence From the Themba

Abstract: In resource-limited settings, early mortality on antire-troviral therapy (ART) is approximately 10%; yet, it is unclear how much of that mortality occurs in care or after lost to follow-up. We assessed mortality rates and predictors of death among 12,222 nonpregnant ART-naive adults initiating first-line ART between April 2004 and May 2012 in South Africa, stratified by person-years in care and lost. We found 14.6 % of patients died and being lost accounted for a minority of deaths across multiple definitions of loss (population attributable-risk percent ranged from 10.4 % to 42.5%). Although mortality rates in patients lost were much higher than in care, most ART-related mortality occurred on treatment. Key Words: antiretroviral therapy, mortality, lost to follow-up, survival, retentio