Temporal Trends in Treatment Outcomes for HIV-1 and HIV-2-Infected Adults Enrolled in Côte d’Ivoire’s National Antiretroviral Therapy Program

Background: In Côte d’Ivoire during 2004–2007, numbers of ART enrollees increased from,5,000 to 36,943. Trends in nationally representative ART program outcomes have not yet been reported. Methodology/Principal Findings: We conducted a retrospective chart review to assess trends in patient characteristics and attrition [death or loss to follow-up (LTFU)] over time, among a nationally representative sample of 3,682 adults ($15 years) initiating ART during 2004–2007 at 34 health facilities. Among ART enrollees during 2004–2007, median age was 36, the proportion female was 67%, the proportion HIV-2-infected or dually HIV-1&2 reactive was 5%, and median baseline CD4+ T-cell (CD4) count was 135 cells/mL. Comparing cohorts initiating ART in 2004 with cohorts initiating ART in 2007, median baseline weight declined from 55 kg to 52 kg (p = 0.008) and the proportion weighing,45 kg increased from 17 % to 22% (p = 0.014). During 2004–2007, pharmacy-based estimates of the percentage of new ART enrollees $95 % adherent to ART declined from 74 % to 60 % (p = 0.026), and twelve-month retention declined from 86 % to 69%, due to increases in 12-month mortality from 2%–4 % and LTFU from 12%–28%. In univariate analysis, year of ART initiation was associated with increasing rates of both LTFU and mortality. Controlling for baseline CD4, weight, adherence, and other risk factors, year of AR