The high incidence of late presenters for HIV/AIDS infection in the Lodz province, Poland in the years 2009-2016: we are still far from the UNAIDS 90% target

AIDS Care. 2018 Dec;30(12):1538-1541. doi: 10.1080/09540121.2018.1470306. Epub 2018 May 20.

Abstract

The present study retrospectively analyses the prevalence of late diagnosis in patients with newly-diagnosed HIV infection in Lodz, Poland from January 2009 to December 2016, and assesses the predictive factors associated with late presenters. Late presentation is defined as a diagnosis of HIV with a CD4 count<350 cells/μL, or the occurrence of an AIDS- defining event, regardless of the CD4 cell count. Two hundred and fifty-nine (62.86%) patients were late presenters, 178 of whom (68.72%) were advanced late presenters (CD4 cell count below 200 cells/μL). Multivariate factors associated with late HIV presentation included referral from physician for HIV testing (OR: 3.95, 95% CI 2.42-6.46), older age (OR: 1.81, 95% CI: 1.38-2.38) and route of HIV transmission. Heterosexual patients (OR 1.98, 95% CI: 1.01-3.90), active drug users (OR: 3.49, 95% CI: 1.63-7.48) and patients who did not report the route of transmission (OR: 4.29, 95%: CI 1.45-12.62) were more likely to present late than MSM subjects. In conclusion, the majority of HIV-infected patients are still diagnosed late. There is a need for expanded testing not only in MSM group, in which HIV prevalence is the highest, but also in intravenous drug users, or among subjects who are heterosexual or from a higher age group.

Keywords: Human immunodeficiency virus; advanced HIV disease; late presentation.

MeSH terms

  • Adult
  • Aged
  • CD4 Lymphocyte Count / statistics & numerical data
  • Delayed Diagnosis / statistics & numerical data*
  • Delayed Diagnosis / trends
  • Drug Users
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • HIV Infections / transmission
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Poland / epidemiology
  • Population Surveillance
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sexual Behavior / statistics & numerical data*
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / epidemiology*