A retrospective cohort study was conducted to determine the incidence and the predictive factors of depression in a cohort of 2737 HIV/AIDS-infected patients in Guadeloupe followed for a total of 8402 patient-years. The incidence rate of first observed depression was 2.2 per 100 person-years (95% confidence interval [CI], 1.9-2.6). A single failure Cox proportional hazards model showed that the 1997-2000 inclusion period (hazard ratio [HR] ¼ 1.60; 95% CI ¼ 1.10-2.40; p ¼ 0.01), the 2001-2009 inclusion period (HR ¼ 1.50; 95% CI ¼ 1.02-2.40; p ¼ 0.04), the more advanced CDC stage (HR ¼ 2.30; 95% CI ¼ 1.30-3.10; p ¼ 0.000) and the annual frequency of visits > 10 (HR ¼ 2.30; 95% CI ¼ 1.70-3.30; p ¼ 0.000) were associated with an increased risk of depression. Incidence of depression in this HIV cohort was high and the hazard function showed three peaks of depression (2, 7 and 12 years). Physicians should be vigilant to psychological distress throughout life with HIV.

International audienceObjective: The objective of this study was to identify the factors associated with presentation for care with CD4 cell count <200/mm3. Design: A Retrospective monocentric cohort study of the Guadeloupe section of French Hospital Database for HIV was conducted. Methods: Group 1 Cohort (CD4 <200/mm3, n=1076), Group 2 (CD4 200-500, n=973) and Group 3 (CD4 >≥ 500/ mm3, n=627) patients were included between 1 January 1988 and 31 December 2009. Factors associated with late presentation (CD4 count <200 cells/μL) were assessed using descriptive statistics and ordered multivariable logistic regression. Results: At the time of diagnosis, 40.21% of patients had than less 200 CD4 lymphocytes/mm3. Age older than 30 years OR: 1.55[1.14-2.10], p=0.005, male gender OR: 1.83[1.58-2.12], p<0.0001, access to care before 1992 OR: 1.56[1.03-2.02], p=0.038 and alcohol use OR: 8.80[2.26-34.36], p=0.002 were independently associated with a low CD4 cell count. Conclusion: The findings of this study (underline the need to expand HIV testing beyond the usual facilities) may be of value in helping to achieve earlier access to treatment in HIV-infected patients in order to minimize the individual risk of morbidity and mortality

Since the pathogen ecology differs between Caribbean regions, specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS) may be expected. We therefore conducted the present retrospective cohort study in order to describe the main AIDS-defining events in Guadeloupe and to compare them with those observed in Metropolitan France and in French Guiana. We discuss the local pathogen ecology, the diagnostic limitations of hospitals in overseas territories and the drivers of the epidemic.