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Page 8 of 8 Editorial

22. Kaplan S, Nteso KS, Ford N, Boulle A, Meintjes G. Loss to The median cohort study size was 3737 persons. Median adult
follow-up from antiretroviral therapy clinics: A systematic age and baseline CD4 count at ART initiation were 35.8 years
review and meta-analysis of published studies in South and 121 cells/mm , respectively. The median age of ART
3
Africa from 2011 to 2015. S Afr J HIV Med. 2019;20(1):a984. initiation in children was 4.2 years. The ‘defined’ follow-up time
https://doi.org/10.4102/sajhivmed.v20i1.984 varied from 9 weeks to 5 years and the meta-analysis indicated
no difference in LTFU estimates at 3-, 6- or 12-month census. The
Editor’s comment: Recommended reading. This review overall median mortality at 1 year was 7.9% (IQR 4.1–11.4; range
article provides a meta-analysis of public sector South African 0% – 26%) and the median LTFU at 1 year was 12.8% (IQR 7.9%
antiretroviral therapy (ART) studies that address loss to – 22.0%, range 0.2% – 43.1%). Aggregate meta-analysis LTFU
follow-up (LTFU) and mortality data. This is an important estimates at 1 year were 11.6% (95% CI 11.4% – 11.7%) in the
article and will inform the epidemiology and practice of ART adult studies, 30.0% (95% CI 28.7% – 37.4%) for the pregnant
in South Africa in the years ahead. cohorts and accounted for 7.5% (95% CI 6.7% – 8.2%) of the
paediatric data. The 5-year LTFU estimate was 25% (95% CI
24.8% – 25.4%) based on three adult studies. In their concluding
The data are derived from 48X adult, 15X paediatric and
4X pregnancy studies completed between January 2011 remarks, the authors indicate their support for the
and October 2015. The study limitations are acknowledged: standardisation of the LTFU definition to 180 days (6 months).
non-homogeneous data sources, namely, clinics, hospitals, Thank you for reading through this summary of articles
rural and urban sites; and non-standardised definitions of published in the Southern African Journal of HIV Medicine
LTFU across sources. When is a client lost to follow-up? After August–December 2019. Similar summaries are available
3, 6 or 12 months since their last visit? The initiation of for the first half of 2019. If you have suggestions and
ART itself was in flux at the time: baseline CD4 counts varied improvements, please contact me at [email protected].
and treatment varied between private and state providers.
Were ‘silent transfers’ excluded from the LTFU data, that is, Dr David Spencer
clients who move between clinics without informing staff Editor-in-Chief
and who are not truly LTFU? Southern African Journal of HIV Medicine

http://www.sajhivmed.org.za 10 Open Access