Table 2. Univariate and multivariate analysis of factors associated with Medical Care Interruption (MCI) at the time of HIV diagnosis and during follow-up of patients seeking HIV Care in the infectious diseases department of Bichat hospital, Paris, between January 2010 and May 2016.
| Hazard ratio* (95% CI) | p-value* | Adjusted hazard ratio** (95% CI) |
p-value** | |
|---|---|---|---|---|
| Fixed variables | ||||
| Age at HIV diagnosis (years) | NS | |||
| ≤30 | 1 | - | ||
| [31–45] | 0.83 (0.70–0.99) | 0.04 | ||
| >45 | 1.02 (0.80–1,30) | 0.86 | ||
| Sex | NS | |||
| Male | 1.17 (0.99–1.39) | 0.06 | ||
| Female | 1 | - | ||
| Country of birth | ||||
| France | 1 | - | 1 | - |
| Sub-Saharan Africa | 0.79 (0.65–0.95) | 0.01 | 0.75 (0.62–0.91) | 0.004 |
| Other countries or data unknowna | 0.94 (0.76–1.16) | 0.55 | 0.90 (0.73–1.12) | 0.35 |
| Residence | ||||
| Ile-de-France | 1 | - | 1 | - |
| Paris (except the 18th arr.) | 1.22 (1.02–1.47) | 0.03 | 1.20 (0.99–1.46) | 0 .06 |
| 18th arrondissement of Paris | 1.39 (1.08–1.79) | 0.01 | 1.38 (1.07–1.78) | 0.01 |
| Other area | 1.15 (0.81–1.65) | 0.44 | 1.13 (0.79–1.63) | 0.50 |
| No available postal code | 2.08 (1.38–3.15) | <0.001 | 2.09 (1.38–3.18) | 0.001 |
| Primary care physicianb | ||||
| Yes | 1 | - | 1 | - |
| No | 2.40 (2.14–2.98) | <0.001 | 2.40 (2.03–2.84) | <0.001 |
| HIV transmission group | NS | |||
| Men who have sex with men | 1 | - | ||
| Heterosexual men and women | 0.96 (0.79–1.17) | 0.71 | ||
| People who inject drugs | 1.24 (0.87–1.78) | 0.24 | ||
| Other or no data availablec | 1.35 (1.07–1.72) | 0.01 | ||
| AIDSd at HIV diagnosis | NS | |||
| Yes | 0.79 (0.57–1.1) | 0.15 | ||
| No | 1 | - | ||
| Hepatitis B coinfection | ||||
| Yes | 0.81 (0.56–1.19) | 0.27 | ||
| No | 1 | - | ||
| Hepatitis C coinfection | NS | |||
| Yes | 0.69 (0.45–1.04) | 0.06 | ||
| No | 1 | - | ||
| HIV viral load at enrollment (copies/mL)e | NS | |||
| ≤1,000 | 1.25 (1.00–1.58) | 0.05 | ||
| 1,001–10,000 | 1.36 (1.05–1.76) | 0.02 | ||
| 10,001–100,000 | 0.96 (0.76–1.21) | 0.73 | ||
| >100,000 | 1 | - | ||
| CD4 count at enrollment (cells/mm3) | NS | |||
| ≤350 | 1 | - | ||
| >350 | 1.13 (0.96–1.33) | 0.15 | ||
| Time period before first visitf | ||||
| ≤6 months | 1 | - | 1 | - |
| >6 months | 1.34 (1.14–1.58) | <0.001 | 1.30 (1.10–1.54) | 0.003 |
| Time between first visit and first ARTg | NS | |||
| ≤12 months | 1 | - | ||
| >12 months | 1.18 (0.99–1.41) | 0.05 | ||
| Time-dependent variables | ||||
| Age (years) | ||||
| ≤30 | 1 | - | ||
| [31–45] | 0.87 (0.62–1.21) | 0.41 | ||
| >45 | 0.75 (0.54–1.05) | 0.10 | ||
| CD4 count (cells/mm3) | ||||
| >500 | 1 | - | 1 | - |
| [351–500] | 1.39 (0.95–2.04) | 0.09 | 1.42 (1.02–2.08) | 0.04 |
| ≤350 | 2.54 (1.80–3.59) | <0.001 | 2.85 (2.02–4.04) | <0.001 |
| Missing data | 4.06 (3.2–5.13) | <0.001 | 3.87 (3.06–4.89) | <0.001 |
| Antiretroviral therapy | ||||
| Yes | 1 | - | 1 | - |
| No | 3.52 (2.79–4.45) | <0.001 | 3.67 (2.90–4.66) | <0.001 |
| AIDS | ||||
| Yes | 0.91 (0.75–1.11) | 0.37 | ||
| No | 1 | - |
MCI: Medical Care Interruption
*Hazard ratios and p-values of univariate Cox models carried out for 4,796 patients
**Hazard ratios and p-values of the final multivariate Cox model (backward procedure) carried out for 4,796 patients. NS: non-significant (p>0.05)
aThe country of birth was missing for 73 participants
bPrimary care physician declared by the patient, written in the computer file, to whom medical records from the clinic are sent
cThe HIV transmission group information was missing for 587 participants
dAIDS: acquired immune deficiency syndrome defined by using the CDC classification
eThe viral load data were missing for 49 participants
fTime between HIV diagnosis and first medical visit in or outside the clinic
gART: antiretroviral therapy, prescribed for 4,652 patients by the end of the study period