A case–control study to assess association of factors with treatment interruption of antiretroviral therapy (ART) among people living with HIV at ART center of tertiary care hospital in Himachal Pradesh, India

Background: Treatment interruption affects virologic suppression during antiretroviral therapy (ART) among people living with HIV (PLHIV). The present study was planned to explore factors associated with Loss to follow-up (LFU) among PLHIVs receiving ART from 2017 to 2021 at ART center of tertiary care hospital in Himachal Pradesh. Materials and Methods: A case–control study where selected PLHIVs registered with ART center of a tertiary care hospital from 2017 to 2021 were assessed with logistic regression for baseline characteristics and possible reasons for treatment interruption among 120 cases (regular) and 124 controls (missed and LFU). Results: Record-based analysis of a total of 703 PLHIV registered at ART center from 2017 to 2021 observed 18.3% LFU of which 70.5% died over 5 years. Adjusted association showed that mean duration of treatment interruption was significantly positively associated with missed (adjusted odds ratio [aOR]: 1.1; 95% confidence interval [CI]: 0.9–1.1), LFU (aOR: 1.1; 95% CI: 1.0–1.2), and combined (missed + LFU) (aOR: 1.1; 95% CI: 1.01–1.2) as compared to regular category. Effect of adverse effects showed a negative significant association with missed (aOR: 0.1; 95% CI: 0.0–0.2) and combined (missed and LFU) (aOR: 0.1; 95% CI: 0.0–0.1) in comparison to regular category. Conclusions: ART services need to be made available further down to health care delivery system and closer to place of residence of PLHIV.