Late presentations among HIV-infected patients
Objective: The late diagnosis of human immunodeficiency virus (HIV) infection and, therefore, initiation of antiretroviral therapy (ART) in the advanced stages of the disease is still a significant problem in many countries. This study aimed to define the prevalence of late presentation and advanced HIV disease among newly diagnosed HIV infected patients.Patients and Methods: The medical records of HIV-infected patients aged 18 and over, diagnosed between January 2011 and December 2019, were analysed retrospectively. The patients were grouped into three-year periods according to the date of diagnosis. Results: Of the 280 patients with HIV infection, 44 (15.7%) were female and 236 (84.3%) were male. It was found that 50.7% of the patients were late presenters, and 28.5% had advanced diseases. There was no statistical difference in the prevalence of late presentation and advanced HIV disease between the three-year periods. While there was no relationship between gender and late presentation, a statistically significant relationship was found between advanced age and late presentation. Conclusion: Despite advances in the diagnosis and treatment of HIV infection, the frequency of late presentation is still quite high, in Turkey. This situation highlights the importance of broad-based HIV screening programs to control the disease more effectively.
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- [1] European Centre for Disease Prevention and Control
[ECDC]. HIV/AIDS surveillance in Europe 2019 – 2018 data.
https://www.ecdc.europa.eu/sites/default/files/documents/
hiv-surveillance-report-2019.pdf. Accessed:10 February 2020.
- [2] Jeong SJ, Italiano C, Chaiwarith R et al. Late presentation into
care of HIV disease and its associated factors in Asia: results
of TAHOD. AIDS Res Hum Retroviruses 2016;32:255-61. doi:
10.1089/AID.2015.0058.
- [3] Panos G, Samonis G, Alexiou VG, Kavarnou GA, Charatsis G,
Falagas ME. Mortality and morbidity of HIV infected patients
receiving HAART: a cohort study. Curr HIV Res 2008;6:257-
60. doi:10.2174/157.016.208784324976.
- [4] Sobrino-Vegas P, Moreno S, Rubio R et al. Impact of late
presentation of HIV infection on short-, mid-and longterm
mortality and causes of death in a multicenter national
cohort: 2004-2013. J Infect 2016;72:587-96. doi: 10.1016/j.
jinf.2016.01.017.
- [5] Jevtović D, Vanovac V, Veselinović M, Salemović D, Ranin
J, Stefanova E. The incidence of and risk factors for HIVassociated
cognitive–motor complex among patients on
HAART. Biomed Pharmacother 2009;63:561-5. doi: 10.1016/j.
biopha.2008.09.015.
- [6] Marks G, Crepaz N, Janssen RS. Estimating sexual transmission
of HIV from persons aware and unaware that they are infected
with the virus in the USA. AIDS 2006;20:1447-50. doi:
10.1097/01.aids.000.023.3579.79714.8d.
- [7] Antinori A, Coenen T, Costagiola D et al. Late presentation of
HIV infection: a consensus definition. HIV Med 2011;12:61-
4. doi: 10.1111/j.1468-1293.2010.00857.x.
- [8] Turkey, Ministry of Health. Statistics of HIV-AIDS. Https://
hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hiv-aidsliste/
hıv-aids-istatislik.html. Accessed:10 February 2020.
- [9] Yemisen M, Aydın OA, Gunduz A et al. Epidemiological
profile of naive HIV-1/AIDS patients in Istanbul: the largest
case series from Turkey. Curr HIV Res 2014;12 :60-4. doi: 10.2
174/1570162x126.661.40411111803.
- [10] Çerçi P, İnkaya AÇ, Alp Ş, Tümer A, Ünal S. Evaluation of
255 HIV/AIDS Cases: Hacettepe Cohort, Ankara, Turkey.
Mikrobiyol Bul 2016;50:94-103. (Turkish) doi: 10.5578/
mb.10610.
- [11] Karaosmanoğlu HK, Mete B, Gündüz A et al. Late presentation
among patients with human immunodeficiency virus
infection in Turkey. Cent Eur J Public Health 2019;27:229-34.
doi: 10.21101/cejph.a5416.
- [12] Petrakis V, Panagopoulos P, Maltsan T et al. Late Presenters of
HIV Infection in an HIV Unit of a Tertiary University Hospital
in a Rural Region of Greece. AIDS Res Hum Retroviruses
2020;36:601-5. doi: 10.1089/AID.2019.0246.
- [13] Siwak E, Horban A, Witak-Jędra M et al. Long-term trends
in HIV care entry: over 15 years of clinical experience from
Poland. HIV Med 2019;20 :581-90. doi: 10.1111/hiv.12762.
- [14] Raffetti E, Postorino MC, Castelli F et al. The risk of late or
advanced presentation of HIV infected patients is still high,
associated factors evolve but impact on overall mortality
is vanishing over calendar years: results from the Italian
MASTER Cohort. BMC Public Health 2016;16:878. doi:
10.1186/s12889.016.3477-z.
- [15] Montlahuc C, Guiguet M, Abgrall S et al. Impact of late
presentation on the risk of death among HIV-infected
people in France [2003-2009]. J Acquir Immune Defic Syndr
2013;64:197-203. doi: 10.1097/QAI.0b013e31829cfbfa.
- [16] Late presenters working group in COHERE in EuroCoord,
Mocroft A, Lundgren J et al. Late presentation for HIV care
across Europe: update from the Collaboration of Observational
HIV Epidemiological Research Europe [COHERE] study,
2010 to 2013. Euro Surveill 2015;20(47) pii=30070. doi:
10.2807/1560-7917.ES.2015.20.47.30070.
- [17] Yombi JC, Jonckheere S, Vincent A, Wilmes D, Vandercam
B, Belkhir L. Late presentation for human immunodeficiency
virus HIV diagnosis results of a Belgian single centre. Acta
Clin Belg 2014;69:33-9. doi: 10.1179/000.155.1213Z.000.000.
00014.
- [18] Wójcik-Cichy K, Jabłonowska O, Piekarska A, Jabłonowska E.
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;30
:1538-41. doi: 10.1080/09540.121.2018.1470306.
- [19] de Olalla PG, Manzardo C, Sambeat MA et al.; HIV
Surveillance Group. Epidemiological characteristics and
predictors of late presentation of HIV infection in Barcelona
[Spain] during the period 2001-2009. AIDS Res Ther 20116;8
:22. doi: 10.1186/1742-6405-8-22.
- [20] Mukolo A, Villegas R, Aliyu M, Wallston KA. Predictors of
late presentation for HIV diagnosis: a literature review and
suggested way forward. AIDS Behav 2013;17 :5-30. doi:
10.1007/s10461.011.0097-6.