title: Continuous free access to HAART could be one of the potential factors impacting on loss to follow-up in HAART-eligible patients living in a resource-limited setting: N'djamena, Chad.
abstract: BACKGROUND
  Retention of HAART-eligible HIV-infected patients in clinical follow-up systems are now becoming an important issue in sub-Saharan African countries.
  
  
  METHODS
  In this retrospective study (April 2008 to November 2011), we assessed the attrition rate variations in a cohort of 509 HAART-eligible patients in Chad.
  
  
  RESULTS
  Decrease in levels of loss to follow-up were observed during the implementation of continuous free access to HAART (72.5 vs 10%; p<0.001) and was independent of gender, age, WHO clinical stage and CD4+ T cell count at inclusion and of the time delay to initiate HAART (p>0.48).
  
  
  CONCLUSIONS
  These data suggest that the implementation of free access to HAART without any interruption of supply, from autumn 2009, could be the factor that potentially changed the HIV patient attrition rate in this resource-limited setting.
authors.affiliation: Service de Médecine interne, Hôpital Le Bon Samaritain, CHU Walia, N'Djamena, Chad.
authors.forename: Oumaïma
authors.initials: O
authors.lastname: Djarma
authors.affiliation: Laboratoire de Virologie médicale et moléculaire Hôpital Robert Debré, CHU Reims & EA-4684, Faculté de Médecine, Reims, France Service de Médecine interne, Maladies infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, France.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Nguyen
authors.affiliation: Laboratoire de Virologie médicale et moléculaire Hôpital Robert Debré, CHU Reims & EA-4684, Faculté de Médecine, Reims, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Renois
authors.affiliation: Service de Médecine interne, Hôpital Le Bon Samaritain, CHU Walia, N'Djamena, Chad.
authors.forename: Alain
authors.initials: A
authors.lastname: Djimassal
authors.affiliation: Laboratoire de Virologie médicale et moléculaire Hôpital Robert Debré, CHU Reims & EA-4684, Faculté de Médecine, Reims, France Service de Médecine interne, Maladies infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, France.
authors.forename: Firouze
authors.initials: F
authors.lastname: Banisadr
authors.affiliation: Service de Médecine interne, Hôpital Le Bon Samaritain, CHU Walia, N'Djamena, Chad Laboratoire de Virologie médicale et moléculaire Hôpital Robert Debré, CHU Reims & EA-4684, Faculté de Médecine, Reims, France landreoletti@chu-reims.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Andreoletti
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D018791:CD4 Lymphocyte Count; D002596:Chad / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008137:Longitudinal Studies; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D040841:Resource Allocation / Q000600:supply & distribution; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult
keywords: Chad; HAART; HIV; Loss to follow-up; Sub-Saharan Africa