8th Annual Conference Of The British HIV Association [BHIVA] 19 – 21 April 2002, University of York, York

[AUTHOR(S):] LJ Haddow¹, SG Edwards¹, K Sinka², DE Mercey^1
1 Royal Free and University College Medical School and ² Communicable Disease Surveillance Centre, Colindale, London

BHIVA Conf 2002 Apr 19-21;8:O18

BACKGROUND: The majority of HIV+ patients are young and some may engage in ongoing high-risk sexual activity. Regular follow-up allows prevention and treatment of HIV complications and may be an opportunity for risk reduction.

AIM: To determine which patients were lost to follow up (LFU) and describe the characteristics of this group.

METHODS: Patients who had not attended during 2001 but had done so in the previous 15 months were defined as LFU. Case notes were reviewed. Data collected included demographics, CD4, viral load (VL), Centers for Disease Control and Prevention (CDC) stage, antiretroviral treatment, co-morbidity and reason for LFU.

RESULTS: Out of 1522 patients, we identified 174 LFU. 69 had documented reasons for LFU (28 transferred to other centres, 24 had their main HIV care elsewhere, 17 died). 11 case notes were not obtained. Of the remaining 94, the median age was 33 years (range 22- 56); 80% were male, 62% white and 21% black African. The main risk behaviour was men having sex with men (65%). Demographic data were not statistically different from those of patients attending for regular follow-up. At the time of last attendance, the median CD4 count was 420 cells/µL (range: 10-1561: 14% CD4 <200). Median VL=12,200 (range: 300-619,300). 61% were CDC A. 28% were taking antiretroviral therapy at last visit. A range of psychological and social issues was identified. Data will be presented on whether they later accessed care at another UK centre (CDSC Colindale).

CONCLUSION: While most patients LFU were at no immediate health risk to themselves, it is of concern that some patients had started antiretroviral therapy, some had advanced disease, and opportunities for health promotion were lost. Patient groups of special concern will be discussed.

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