Facteurs influençant la perte de vue et la mortalité chez les personnes vivant avec le VIH suivies au Centre de Traitement Ambulatoire de Koula-Moutou (Gabon) de 2005 à 2015

Introduction: This study aimed primarily to evaluate the biological and clinical factors associated with visual loss and mortality in patients treated at the Outpatient Treatment Center HIV / AIDS (CTA) of Koula-Moutou. Methods: From 2005 to 2015, 1268 patients were treated at OTC. Serological diagnosis of HIV and CD4 T-cell count was determined using Determine, SD Bioline, Immunocombs commercial kits and FACS Count Reagents respectively. Results: The majority of patients treated were female (66.8%) and underwent first line antiretroviral therapy (ART) (63.3%). Vision loss and mortality affected 33.5% and 24.6% of patients respectively. Vision loss was significantly associated with the failure to take ART (p < 0.001) and CD4 cell count<500 cells/mm(3) at baseline (p<0.001). Mortality was higher in men than in women (p = 0.006). It was significantly reduced in patients on first line ART (p = 0.003) and in those with CD4 cell count > 500 cells / mm(3) at baseline (p<0.001). The mortality of patients was very high at the opening of the OTC in 2005, but has experienced a significant reduction between 2013 and 2015 from 4.8% to 1.6% (p<0.001). Conclusion: This study describes the epidemiology of HIV in a rural area of Gabon. It higlights the causes of vision loss and mortality in patients treated in one of the ten (10) OTC in the country.