3. Follow-up

Following the initiation of therapy, a patient is seen regularly at 1 month, and then every three months by his/her physician at the accredited center to assess response to therapy. Blood samples are drawn and sent to Projet RETRO-CI's laboratory for serum chemistry, hematology, CD4 counts and other immunological markers, and viral load testing. The clinician may modify the ARV regimen according to these results, if necessary.

The following procedures have been implemented to facilitate the transfer of forms and specimens between the six participating centers and Projet RETRO-CI. Each patient entering the initiative has a personal identification number. Data from the questionnaires are entered into one database; names and personal identifiers are entered into a separate database; access to this latter database is strictly limited to two persons.

Thereafter, any additional questionnaires and specimens collected will be identified by the personal identification number and not by any other personal identifier. Each time that a questionnaire is administered, taken to Projet RETRO-CI, and entered into the database, a copy is sent to the attending physician for the patient's hospital record.

The staging process used in this Initiative distinguishes three different populations:

1) patients who want to access this initiative,
2) patients who return after the eligibility screening to find out the result of their request, and
3) patients who have been successful in obtaining ARV therapy.

In order to evaluate this program, information from patients belonging to these three different populations was collected since August 1998. All this information has been centralized at Projet RETRO-CI and monthly reports have been generated. These reports are discussed during regular meetings with representatives of the different centers involved in this evaluation.