RESEARCH PAPER
Late presenters among newly diagnosed HIV-infected in Poland in 2006-2008
 
More details
Hide details
 
Submission date: 2017-07-25
 
 
Final revision date: 2017-11-09
 
 
Acceptance date: 2017-11-12
 
 
Publication date: 2017-12-06
 
 
HIV & AIDS Review 2017;16(4):244-250
 
KEYWORDS
TOPICS
ABSTRACT
Introduction: Assessment of incidence and factors associated with late vs. early human immunodeficiency virus (HIV) diagnosis among newly diagnosed patients referred to HIV treatment centres in Poland in the years 2006-2008.
Material and methods: Retrospective analysis of medical records of patients reported from eight regional centres for HIV treatment in Poland in years 2006-2008 was conducted. The study population consisted of 1132 HIV-infected pa-tients newly diagnosed with HIV infection, aged 17 years up. To describe characteris-tics of this group of patients in terms of clinical and immunological presentation mul-tivariate regression analysis of demographic and epidemiology data including: sex, age, mode of transmission, CD4 T cell count, and viral load at the time of diagnosis was performed.
Results: Among 1132 patients included in the study 564 (49.8%) were late presenters (LP) according to European consensus definition. In multivariate logistic analysis including sex, age and route of infection, as independent factors, age (OR = 1.06), intravenous drug use (OR = 2.17 for IVDU vs. MSM), and heterosexuality (OR = 2.07 for Hx vs. MSM) were risk factors for late testing. The same factors were pre-dictors of advanced HIV disease, as well as unknown route of infection (OR = 1.77; p < 0.05). However, multivariate regression analysis revealed that only advanced age was an independent factor influencing lower CD4 T cell count and late presentation (OR = 1.02 per 1 year of age, p < 0.001).
Conclusions: Nearly 50% of patients were diagnosed after the optimal time for antiretroviral treatment initiation, according to actual European and Polish guide-lines. These results strongly point out the necessity of further encouragement toward more frequent and earlier HIV testing.
 
REFERENCES (35)
1.
Reekie J, Kowalska JD, Karpov I, et al. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: the EuroSIDA study. PLoS One 2012; 7: e41673.
 
2.
Dokuzoguz B, Korten V, Gokengin D, et al. Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012. J Int AIDS Soc 2014; 17 (4 Suppl 3): 19595.
 
3.
Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet 2008; 372: 293-299.
 
4.
Battegay M, Fehr J, Fluckiger U, Luigia E. Antiretroviral therapy of late presenters with advanced stage of disease. J Antimicrob Chemother 2008; 62: 41-44.
 
5.
Moreno S, Mocroft A, Monforte A. Medical and societal consequences of late presentation. Antivir Ther 2010; 15 Suppl 1: 9-15.
 
6.
Waters L, Fisher M, Anderson J, et al.; UK CHIC Steering Committee. Responses to highly active antiretroviral therapy and clinical events in patients with a low CD4 cell count: late presenters vs. late starters. HIV Med 2011; 12: 289-298.
 
7.
Brenner BG, Roger M, Routy JP, et al.; Quebec Primary HIV Infection Study Group. High rates of forward transmission events after acute/early HIV-1 infection. J Infect Dis 2007; 195: 951-959.
 
8.
Adler A, Mounier-Jack S, Coker RJ. Late diagnosis of HIV in Europe: definitional and public health challenges. AIDS Care 2009; 21: 284-293.
 
9.
Girardi E, Sabin CA, Monforte AD. Late diagnosis of HIV infection: epidemiological features, consequences and strategies to encourage earlier testing. Acquir Immune Defic Syndr 2007; 46 Suppl 1: S3-8.
 
10.
Fleishman JA, Yehia BR, Moore RD, Gebo KA; HIV Research Network. The economic burden of late entry into medical care for patients with HIV infection. Med Care 2010; 48: 1071-1079.
 
11.
Krentz HB, Gill MJ. The Direct Medical Costs of Late Presentation (< 350/mm) of HIV Infection over a 15-Year Period. AIDS Res Treat 2012; 2012: 757135.
 
12.
Antinori A, Coenen T, Costagiola D, et al.; European Late Presenter Consensus Working Group. Late presentation of HIV infection: a consensus definition. HIV Med 2011; 12: 61-64.
 
13.
Werbińska-Sienkiewicz B, Rosińska M, Furman S. HIV and AIDS in Poland in 2009. Przegl Epidemiol 2011; 65: 289-295.
 
14.
Werbińska-Sienkiewicz B, Staszewska E, Rosińska M. HIV and AIDS in Poland in 2008. Przegl Epidemiol 2010; 64: 265-271.
 
15.
Anon. 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults. Available from http://www.cdc.gov/mmwr/previe....
 
16.
European AIDS Clinical Society Guidelines V6. Availabale from http://www.europeanaidsclinica....
 
17.
Horban A, Podlasin R, Cholewińska G, et al. Principles of HIV patients care. Guidelines of Polish Scientific Society AIDS. EkoPress, Bialystok 2011; 405 [In Polish].
 
18.
Wolbers M, Bucher HC, Furrer H, et al.; Swiss HIV Cohort Study. Delayed diagnosis of HIV infection and late initiation of antiretroviral therapy in the Swiss HIV Cohort Study. HIV Med 2008; 9: 397-405.
 
19.
Ndiaye B, Salleron J, Vincent A, et al. Factors associated with presentation to care with advanced HIV disease in Brussels and Northern France: 1997-2007. BMC Infect Dis 2011; 11: 11.
 
20.
Borghi V, Girardi E, Bellelli S, et al. Late presenters in an HIV surveillance system in Italy during the period 1992-2006. J Acquir Immune Defic Syndr 2008; 49: 282-286.
 
21.
de Olalla PG, Mazardo C, Sambeat MA, et al.; the HIV Surveillance Group. Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009. AIDS Res Ther 2011; 8: 22.
 
22.
Smith RD, Delpech VC, Brown AE, et al. HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS 2010; 24: 2109-2115.
 
23.
Begovac J, Gedike K, Lukas D, et al. Late presentation to care for HIV infection in Croatia and the effect of interventions during the Croatian Global Fund Project. AIDS Behav 2008; 12 (4 Suppl): S48-53.
 
24.
Leutscher PD, Laursen T, Andersen B, et al. HIV late presenters in Denmark: need for increased diagnostic awareness among general practitioners. Dan Med Bull 2011; 58: 4253-4257.
 
26.
Iwuji CC, Churchill D, Gilleece Y, et al. Older HIV-infected individuals present late and have a higher mortality: Brighton, UK cohort study. BMC Public Health 2013; 13: 397.
 
27.
May M, Sterne JA, Sabin C, et al.; Antiretroviral Therapy (ART) Cohort Collaboration. Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. AIDS 2007; 21: 1185-1197.
 
28.
Uy J, Armon C, Buchacz K, et al.; HOPS Investigators. Initiation of HAART at higher CD4 cell counts is associated with a lower frequency of antiretroviral drug resistance mutations at virologic failure. J Acquir Immune Defic Syndr 2009; 51: 450-453.
 
29.
Adults and Adolescents Guidelines. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. U.S. Department of Health and Human Services (DHHS). Available from http://www.aidsinfo.nih.gov/gu....
 
30.
Keusch GT, Wilentz J, Kleinman A. Stigma and global health: developing a research agenda. Lancet 2006; 367: 525-527.
 
31.
Yazdanpanah Y, Lange J, Gerstoft J, et al. Earlier testing for HIV-how do we prevent late presentation? Antivir Ther 2010; 15 Suppl 1: 17-24.
 
32.
Dowson L, Kober C, Perry N, et al. Why some MSM present late for HIV testing: a qualitative analysis. AIDS Care 2012; 24: 204-209.
 
33.
Lazarus JV, Jürgens R, Weait M, et al. Overcoming obstacles to late presentation for HIV infection in Europe. HIV Med 2011; 12: 246-249.
 
34.
HIDES: Indicator Diseases across Europe Study. Retrieved from http://newsite.hiveurope.eu/On....
 
35.
Raben D, Mocroft A, Rayment M, et al. Auditing HIV Testing Rates across Europe: Results from the HIDES 2 Study. PLoS One 2015; 10: e0140845.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top