Incidence and Risk Factors for Follow-Up Interruption of HIV-Infected Patients in Guadeloupe

International audienceBackground: Guadeloupe is the region of France with the second highest prevalence of HIV. Methods: To determine the risk factors for being lost to follow-up (LFU), a retrospective cohort study of 2,732 patients followed between 1988 and 2009 was conducted, and determined which variables were related to being LFU, i.e. permanently disappearing from HIV clinics or coming back after more than one year of missed appointments. Results: The incidence rate for permanent follow-up interruption was 9 per 100 person-years (8.3-9.7 personyears). The median time of LFU was 6.4 years (interquartile range 3-16.9 years). Cox modelling showed that the younger age groups (HR: 1.60[1.30-2.10], p=0.000) and patients diagnosed before 1997 (HR: 4.80[3.50-6.50], p=0.000) were significantly more likely to be permanently LFU. However, patients treated with HAART had a lower risk of being LFU (HR: 0.63[0.51-0.80], p=0.000). Conclusion: These results suggest that some patients may have died. They also allow to quantify the magnitude of a major yet often under-recognized problem and to identify its predictors in the context of Guadeloupe. This could help clinicians improve patient retention

What is AIDS in Guadeloupe? A descriptive and comparative study.

International audienceSince the pathogen ecology differs between Caribbean regions, specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS) may be expected. We therefore conducted the present retrospective cohort study in order to describe the main AIDS-defining events in Guadeloupe and to compare them with those observed in Metropolitan France and in French Guiana. We discuss the local pathogen ecology, the diagnostic limitations of hospitals in overseas territories and the drivers of the epidemic