Factors of loss to follow-up during tuberculosis treatment in a low-incidence region.

• Our study confirmed the major role of loss to follow-up in the low proportion of successful TB treatment in northern France. • Previous history of TB treatment was independently associated with an increased risk of loss to follow-up, while HIV infection was associated with a reduced risk. • The reduced risk of loss to follow-up in case of HIV infection could be explained by specific measures targeting HIV-infected patients to improve compliance. • The implementation of similar supportive measures for patients at risk of loss to follow-up, especially patients with a history of TB treatment, should be evaluated. The proportion of successfully treated tuberculosis (TB) patients remains below the WHO target in France, because of a high proportion of loss to follow-up. We aimed to identify factors associated with loss to follow-up in northern France, a low-incidence area. Between 1997 and 2017, all consecutive patients diagnosed with TB at the Tourcoing Hospital, except those infected with multidrug-resistant or extensively drug-resistant strains, were included in a retrospective cohort study. A logistic regression analysis was performed to determine factors associated with loss to follow-up. One hundred and ninety patients were included. Previous TB treatment was reported in 32 patients (17%), extrapulmonary TB in 107 (56%), and HIV infection in 44 (23%). The proportion of loss to follow-up was 15%. In multivariate analysis, the risk of loss to follow-up decreased in case of first TB treatment (OR 0.36; 95% CI: 0.14–0.92, P = 0.03) and increased in non-HIV-infected patients (OR 7.67; 95% CI: 1.00–59.0, p = 0.05). Support for compliance was more frequent in HIV-infected patients (23% vs. 7%, p = 0.005). The proportion of loss to follow-up was high. HIV infection was associated with a lower risk of loss to follow-up, likely to be due to more frequent support for compliance. [ABSTRACT FROM AUTHOR]