title: Loss of HIV-infected patients on potent antiretroviral therapy programs in Togo: risk factors and the fate of these patients.
abstract: BACKGROUND
  National programs are facing challenges of loss to follow-up of people living with HIV/AIDS (PLWHA) on antiretroviral therapy (ART). We sought to identify risk factors associated with early loss to follow-up among HIV-infected patients on ART in Togo and the outcome of such patients.
  
  
  METHODS
  This was a retrospective cross-sectional study using medical records of all patients older than age 15 years enrolled at 28 treatment centers who were on ART programs and who were lost to follow-up from 2008 to 2011.
  
  
  RESULTS
  Of the 16,617 patients on ART, 1,216 (7.3%) were lost to follow-up. Most (94.1%) were infected with HIV-1 and 32.6% were in WHO stage III or IV. The median CD4 count was 118/mm3 (IQR: 58-178 cells/mm3). No telephone number was mentioned in the medical records of 212 patients. Of the 1004 patients whose phone number was listed, 802 patients (79.9%) were not reachable on the recorded number, 114 patients (11.4%) were alive and 88 patients (8.8%) had died. In multivariate analysis, factors associated with loss to follow-up during the first 6 months of ART were: age below 35 years (OR = 1.6; 95%CI: 1.2-2.2), female sex (OR = 1.8; 95%CI: 1.3-2.5), WHO stage III or IV (OR = 1.7; 95%CI: 1.3-2.2), existence of an opportunistic infection (OR = 2.3; 95%CI: 1.5-3.1), and follow-up in a public centre (OR = 1.9; 95%CI: 1.2-3.3).
  
  
  CONCLUSIONS
  This study identified several factors associated with lost to follow-up during the first 6 months of ART, and confirmed high mortality among these patients. The National AIDS Program should strengthen medical support of PLWHA in Togo including active case follow-up.
authors.affiliation: Service de dermatologie et infections sexuellement transmissibles, Centre Hospitalier Universitaire Sylvanus Olympio, Lomé, Togo.
authors.forename: Bayaki
authors.initials: B
authors.lastname: Saka
authors.forename: Dadja Essoya
authors.initials: DE
authors.lastname: Landoh
authors.forename: Akouda
authors.initials: A
authors.lastname: Patassi
authors.forename: Stephane
authors.initials: S
authors.lastname: d'Almeida
authors.forename: Assetina
authors.initials: A
authors.lastname: Singo
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
authors.forename: Palokinam Vincent
authors.initials: PV
authors.lastname: Pitché
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009313:National Health Programs / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014037:Togo / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents
keywords: Africa; HIV; Togo; human immunodeficiency virus; lost to follow-up; people living with HIV