Incidence and determinants of loss to follow up of hiv1 infected patients on treatment at the yaoundé jamot hospital

CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PL193

The widespread use of highly active antiretroviral therapy (HAART) has changed the landscape of human immunodeficiency virus (HIV) infection from a highly fatal condition to a chronic illness. Unfortunately loss to follow up (LTFU) has emerged as a major threat to the success of HIV programmes. 
Determine the incidence and identify the determinants of LTFU in HIV-1 infected adults on HAART at the Yaounde Jamot Hospital (YJH). 

It was a retrospective cohort of all previously untreated HIV-1 infected adults initiated on ART and followed-up at the approved treatment centre(ATC) of the YJH between January 2011 and December 2012. We analysed socio-demographic, baseline clinical and biological characteristics and treatment regimens, as well as treatment outcomes. Patients at least two months late for scheduled appointment were considered as LTFU.
A total of 793 patients fulfilled the inclusion criteria. At the end of the 12 month period of follow-up 411 (51.8%) of the 793 patients studied were alive and on treatment while 305 were LTFU, giving a cumulative incidence of LTFU of 38.5%. In a multivariate logistic regression analysis, those LTFU were significantly more likely to be aged less than 40 years [OR: 1.56; 95% CI:1.13-2.15], of the male sex [OR: 1.66; 95% CI: 1.18-2.33], single patients [OR:1.83;95%CI :1.32-2.53], with baseline CD4 cell counts<100/mm3 [OR:1.67; 95% CI:1.19-2.33]and no prescription of additional drugs during follow-up[OR: 2.97; 95% CI: 2.07- 4.27].

The annual incidence of LTFU from ART among HIV1 infected patients in the ATC of the YJH is quite high. Age less than 40 years, the male sex, being single, having baseline CD4 cell count below 100/mm3 and no prescription of additional drugs during follow-up are independent determinants of LTFU. To redress the problem of LTFU adequate strategies must therefore be developed to target persons on HAART with these determinants.

Incidence, determinants, HIV, Loss to follow-up, Yaounde