Incidence rate and risk factors for loss to follow-up in a French clinical cohort of HIV-infected patients from January 1985 to January 1998.
OBJECTIVE
To determine the incidence rate and risk factors for loss to follow-up (LFU) in HIV-infected individuals.


METHODS
We estimated the incidence rate of LFU in 1756 HIV-infected patients enrolled in the Tourcoing Clinical Cohort from January 1985 to January 1998. We then investigated potential LFU risk factors at inclusion through a case-control study. Cases were 209 patients who had attended neither our clinic nor another HIV clinic for at least 1 year. Controls were 209 patients randomly selected from the group of HIV-infected patients followed up regularly.


RESULTS
The incidence of LFU was estimated at 4.3 per 100 person-years [95% confidence interval (CI) 3.7-4.9]. Independent risk factors for LFU were (i) year of enrolment before 1993 [odds ratio (OR) 6.7; 95% CI 2.7-16.5 versus after 1997]; (ii) year of enrolment between 1993 and 1997 (OR 5.1; 95% CI 2.0-13.0 versus after 1997); (iii) age<30 years (OR 1.8; 95% CI 1.0-3.5 versus >40 years); (iv) injecting drug use (OR 5.3; 95% CI 2.7-10.5 versus men who have sex with men); (v) homelessness and/or illegal immigrant status (OR 2.2; 95% CI 1.0-4.9); and (vi) lack of a primary care provider (OR 6.0; 95% CI 2.4-15.1). A history of an AIDS-defining illness (OR 0.3; 95% CI 0.2-0.6) and a history of psychiatric disease (OR 0.4; 95% CI 0.3-0.8) were both associated with a decreased risk of LFU.


CONCLUSIONS
This study assessed the sociodemographic, clinical and behavioural characteristics associated with LFU in HIV-infected patients. The findings of this study may allow clinicians to identify patients at risk of LFU, so that appropriate interventions may be initiated.
Department of Infectious Diseases, Tourcoing AIDS Reference Center, Dron Hospital, Tourcoing, France. bertrand.lebouche@chu-lyon.fr
B
B
Lebouché
Y
Y
Yazdanpanah
Y
Y
Gérard
D
D
Sissoko
F
F
Ajana
I
I
Alcaraz
P
P
Boitte
B
B
Cadoré
Y
Y
Mouton
D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D015497:HIV-1; D006716:Homosexuality; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D010352:Patient Dropouts; D012307:Risk Factors; D012923:Social Class; D013997:Time Factors
D019380:Anti-HIV Agents