Lost To Follow-Up Pada Pasien Tuberkulosis Dengan Koinfeksi HIV: Tinjauan Sistematis

Ayu Rahayu; Najmah Najmah; Iche Andriyani Liberty

doi:10.31004/koloni.v5i3.1436

Authors

Ayu Rahayu Universitas Sriwijaya
Najmah Najmah Universitas Sriwijaya
Iche Andriyani Liberty Universitas Sriwijaya

DOI:

https://doi.org/10.31004/koloni.v5i3.1436

Keywords:

tuberculosis, HIV coinfection, lost to follow-up, adherence, systematic review.

Abstract

This study aimed to review the proportion of lost to follow-up (LTFU) and factors associated with LTFU among patients with drug-sensitive tuberculosis and HIV coinfection. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were performed through PubMed, Scopus, and ScienceDirect for articles published between 2020 and 2025. Article selection was conducted using Rayyan, resulting in 16 observational studies that met the inclusion criteria. The findings showed that the proportion of LTFU varied widely, with the lowest proportion being approximately 1% and the highest reaching 95%, particularly among vulnerable populations. Factors associated with LTFU included advanced HIV stage, low CD4 count, delayed initiation of antiretroviral therapy, anemia, socioeconomic limitations, stigma, transportation difficulties, substance use, and limited social support. Health system factors, including weak integration of TB and HIV services, inadequate treatment adherence support, and suboptimal patient follow-up mechanisms, also contributed to LTFU. In conclusion, LTFU remains a major barrier to successful TB treatment among patients with HIV coinfection. Strengthening integrated services and implementing patient-centered approaches are essential to reduce LTFU and improve treatment outcomes.

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