EACS2023: 723 Predictors of retention in care among people living with HIV: an Egyptian cross-sectional study H. Karam-Allah Ramadan , R. Mohamed , A. Hatem , M. Essam , N. El Garhy , L. Al Sehemy , R.A. Awad , M. Ismail Abdelraouf , A.M. Al-sharif , M. Sherif , A. Ramadan , S. Hassany , E. El Khateeb , Z. Ali Elsaadany , G. Esmat , A. Cordie Assiut University, Department of Tropical Medicine and Gastroenterology, Assiut, Egypt, Cairo University, Cairo University Hospitals HIV Clinic, Endemic Medicine Department, Cairo, Egypt, Cairo University, Kasr Al-Aini HIV and Viral Hepatitis Fighting Group, Cairo University Hospitals, Cairo, Egypt, Faculty of Engineering, Université de Sherbrooke, Department of Chemical & Biotechnology Engineering, Sherbrooke, Quebec, Canada, Cairo University, Department of Clinical and Chemical Pathology, Cairo, Egypt, Cairo University, Endemic Medicine Department, Cairo, Egypt General data Abstract category: Access and delivery of care Abstract body Purpose: Retention in care among people living with HIV (PLWH) and adherence to antiretroviral therapy (ART) are cornerstones in achieving viral elimination and controlling disease transmission. This study aimed to evaluate the predictors of retention in care among Egyptian PLWH. Method: PLWH attending Cairo University Hospital HIV Clinic between Jan 2019 - July 2022 were included. Failed retention in care was defined as lack of outpatient clinical examination and/or ART withdrawal and/or absence of laboratory tests for 6 consecutive months prior to the study endpoint (March 2023). Demographic data, duration of living with HIV, co-morbidities, hepatitis B virus (HBV) or hepatitis C (HCV) co-infections, opportunistic infections, vaccinations, HIV viral load (VL), CD4+ levels, and type of ART were evaluated. Multivariate regression analysis was used to identify the predictors of retention in care. Results: A total of 387 PLWH were recruited. Retention in care was observed in 325 (84%). Mortality was reported in 1.81% and referral to other centers in 2.84% (Fig. 1). After excluding dead and referred ones, patients were predominantly males (81.8%) and had a median age of 34 [29-41] years. Treatment profile, CD4 count and viral load for the studied population are shown in Table 1. Predictors of retention in care were: having undetectable VL (adjusted odds ratio [a OR]: 3.6; 95% CI: 1.49-8.47), access to CD4 testing (a OR: 2.6; 95% CI: 1.02-6.64), longer duration since HIV diagnosis (a OR: 1.025; 95% CI: 1.01-1.04), a history of HBV vaccination (a OR: 2.835; 95% CI: 1.07-7.48), and being on dolutegravir (DTG)-based ART (a OR: 2.42; 95% CI: 1.06-5.537). However, university and higher education levels were negatively correlated with retention in care (Table 2). Fig. 1 Table 1. Treatment profile, CD4 count and viral load for the studied population Variables Total N= 369 (n, %) Not retained N=44 (n, %) Retained N=325 (n, %) P value Duration of living with HIV (months) Median [IQR] 25 [12- 59] 7.5 [1-14] 34 [14-59] < 0.001* Current ART: 0.008* DTG 304 (82.4) 30 (68.2) 274 (84.3) EFV 65 (17.6) 14 (31.8) 51 (15.7) ART interruption 31 (8.4) 4 (9.1) 27 (8.3) 0.776 Initial CD4: Availability 86 (23.3) 28 (63.6) 58 (17.8) <0.001* Median [IQR] 356 [147.5-556] 435 [168-720] 322 [139-532] 0.247 Last CD4: Availability 286 (77.5) 26 (59.1) 259 (79.9) 0.004* Median [IQR] 450 [257.5-700] 454 [220-889] 450 [277-700] 0.887 Initial HIV viral load: Availability 65 (17.6) 22 (50) 43 (13.2) <0.001* Median [IQR] 33000 [3700-136500] 17200 [4058-150000] 53000 [12983-122000] 0.185 Last measured HIV viral load: Availability 308 (83.5) 28 (63.6) 280 (86.2) <0.001* Undetectable 206 (55.8) 11 (25) 195 (60) <0.001* * Significant p value Table 2. Logistic regression analysis of retention in care Variables OR P value Confidence Interval 95% Lower level Upper level University or postgraduate education 0.195 0.001* 0.071 0.533 HBV vaccine 2.835 0.035* 1.074 7.483 ART (DTG) 2.429 0.035* 1.065 5.537 Duration of living with HIV 1.025 0.001* 1.010 1.040 Availability of last measured HIV viral load 1.705 0.332 0.580 5.013 Undetectable HIV viral load 3.555 0.004* 1.492 8.473 Availability of last measured CD4 2.604 0.045* 1.021 6.642 Conclusions: Securing access to VL and CD4+ testing, improving vaccination coverage, and overarching DTG-based ART can improve retention in care among Egyptian PLWH. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 2,3 2 2 2 2 2 2 2 2 4 1 5 5 6 2,3 1 2 3 4 5 6 40 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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