title: Likely effect of the 2014 Ebola epidemic on HIV care in Liberia.
abstract: OBJECTIVE
  Liberia's health system has been severely struck by the 2014 Ebola epidemic. We aimed to assess the potential effect of this epidemic on the care of HIV patient in two clinics [John F. Kennedy (JFK) and Redemption Hospitals] in Monrovia, which stayed open throughout the epidemic.
  
  
  METHODS
  A preexisting electronic database of HIV patient's follow-up visits was used to estimate three weekly parameters from January 2012 to October 2014: number of visits, number of new patient, and proportion of patients with follow-up delay. We used segmented negative binomial regressions to assess trends before and after the week of the Ebola outbreak defined in June 2014 by WHO.
  
  
  RESULTS
  The cumulative number of patients in care comprised 5948 patients with a total of 56 287 visits between January 2012 and October 2014. From June 2014, the number of visit per week, stable since 2012, abruptly decreased (59%) in Redemption (P < 0.001) and progressively decreased by 3% per week in JFK (P < 0.001). In both the clinics, the weekly proportion of patient with follow-up delay sharply increased after the point break from June 2014 (P value < 0.001). From June 2014, a significant decrease in new patients per week occurred in both the clinics: by 57% (P value < 0.001) in Redemption and by 4.6% per week (P value < 0.001) in JFK.
  
  
  CONCLUSIONS
  The Ebola epidemic had a significant effect on HIV care in Monrovia. Given the particular impact on the rate of patients with follow-up delay, a long-term impact is feared.
authors.affiliation: aINSERM, IAME, UMR 1137 bAP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris, France cInfectious Diseases Clinic, Redemption Hospital dInfectious Diseases Clinic, John F. Kennedy Medical Center, Monrovia, Liberia eEnsemble pour une Solidarité Thérapeutique en Réseau (GIP-ESTHER), Paris fCentre Hospitalo-Universitaire de Rennes, Service de Maladies Infectieuses et Tropicales, Rennes gUniversité Paris Diderot, IAME, UMR 1137, Paris, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Loubet
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mabileau
authors.forename: Maima
authors.initials: M
authors.lastname: Baysah
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nuta
authors.forename: Masietta
authors.initials: M
authors.lastname: Taylor
authors.forename: Hawa
authors.initials: H
authors.lastname: Jusu
authors.forename: Harry
authors.initials: H
authors.lastname: Weeks
authors.forename: Anne
authors.initials: A
authors.lastname: Ingels
authors.forename: Marion
authors.initials: M
authors.lastname: Perennec-Olivier
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chapplain
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cartier
authors.forename: Pierre
authors.initials: P
authors.lastname: Mendiharat
authors.forename: Gilles
authors.initials: G
authors.lastname: Raguin
authors.forename: Pierre
authors.initials: P
authors.lastname: Tattevin
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
mesh_terms: D000328:Adult; D058872:Epidemics; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000628:therapy*; D006298:Health Services Administration / Q000592:standards* / Q000639:trends; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006801:Humans; D007988:Liberia / Q000453:epidemiology; D008297:Male