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RISK FACTORS FOR FOLLOW-UP INTERRUPTION OF HIV PATIENTS IN FRENCH GUIANA

French Guiana is the region of France where the HIV epidemic is most prevalent. To determine the risk factors for being lost for follow-up, we followed a cohort of 1,213 patients between 1992 and 2002 and determined which variables were related to two definitions of being lost to follow-up: permanently disappearing from HIV clinics and coming back after more than 1 year of missed appointments. The incidence rate for permanent follow-up interruption was 17.2 per 100 person-years. The median time to lost to follow-up was 4.3 years (interquartile range = 1.4–8.4 years). Cox modeling showed that the younger age groups, foreigners, patients with initial CD4 counts at the time of HIV diagnosis less than 500/mm³, and patients followed before the availability of highly active antiretroviral therapy (HAART) were significantly more likely to be permanently lost to follow-up, suggesting that some of the patients may have died. When looking at temporary loss to follow-up, younger age groups, untreated patients, patients consulting before the availability of HAART, and patients with CD4 counts more than 500/mm³ were more likely to not come back for a period of more than 1 year.

Received May 12, 2005. Accepted for publication January 6, 2006.

Acknowledgment: We thank Sergine Soyon and Karine Verin for data entry and management.

^* Address correspondence to Mathieu Nacher, CISIH, Center Hospitalier Andrée Rosemon, Rue des Flamboyants, 97306 Cayenne, French Guiana. E-mail: m_nacher{at}lycos.com

Authors’ addresses: Mathieu Nacher and Christian Magnien, Centre d’Information et de Soins de l’Immunodéficience Humaine (CISIH) de Guyane and Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, 97306, Cayenne, French Guiana. Myriam El Guedj and Tania Vaz, Hôpital de Jour Adultes, Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, 97306, Cayenne, French Guiana. Valéry Nasser and Andry Randrianjohany, Service de Médecine, Centre Hospitalier Frank Joly, Ave du Général De Gaulle, 97320, Saint Laurent du Maroni, French Guiana. Fernand Alvarez, Service de Médecine, Centre Médico Chirurgical de Kourou, 97310 Kourou, French Guiana. Milko Sobesky, Département d’Information Médicale, Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, 97306, Cayenne, French Guiana. Pierre Couppié, Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, 97306, Cayenne, French Guiana.