Evaluation of the late presentation and associated factors of people living with HIV in Turkey

Sevgi, Dilek Yildiz; Demirbas, Nazife Duygu; Genc Yaman, Irem; Derin, Okan; Oncul, Ahsen; Atasoy Tahtasakal, Ceren; Gul, Ozlem; Diktas, Husrev; Dokmetas, Ilyas

doi:10.1002/jmv.28781

Cited by 3 publications

(1 citation statement)

References 51 publications

(180 reference statements)

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“…Other studies performed during a similar timeframe (2017 to 2020, 2019 to 2020 and 2015 to 2020) also revealed that male and older patients are at greater risk of late HIV presentation [ 23 , 24 , 25 ]. Additionally, other LP risk factors, including bisexual transmission, heterosexual transmission, being married, SSA origin, tuberculosis or hepatitis C virus coinfection, lower socioeconomic status and the fear of stigma, have been reported in various studies [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The discrepancies observed among those studies highlight the importance of identifying populations at risk of late presentation and developing specific guidelines according to the region.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Late HIV Presentation in Patients Treated at a Single Belgian Reference Centre from 2018 to 2022

Scaia,

Fombellida,

Maes

et al. 2024

Infectious Disease Reports

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A late HIV diagnosis is associated with increased mortality and morbidity, increased healthcare costs and increased onward viral transmission. In this regard, we retrospectively analysed the characteristics of patients who presented for care at our centre from January 2018 to December 2022 to assess the proportion of patients and factors associated with late HIV presentation. We collected data from the Liège University Hospital database, and we used binary logistic regression models to analyse the impact of individuals’ characteristics on late presentation. Among 167 participants, 38.3% were late presenters (LPs) (presenting for care with a CD4+ T-cell count < 350 cells/mm3 or after an AIDS-defining event), and 21.6% were late presenters with advanced disease (LPs-AD) (presenting for care with a CD4+ T-cell count < 200 cells/mm3 or after an AIDS-defining event). The risk of being an LPs-AD was increased in older individuals (OR on log-transformed age: 7.5) and individuals of sub-Saharan African origin compared to individuals of Belgian or other origin (ORs of 0.30 and 0.25, respectively). The results of this study suggest that broadening the focus beyond the previously common risk groups is essential to prevent late diagnosis.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Late HIV Presentation in Patients Treated at a Single Belgian Reference Centre from 2018 to 2022

Scaia,

Fombellida,

Maes

et al. 2024

Infectious Disease Reports

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Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Tsai,

Bai,

Hsieh

et al. 2024

Preprint

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Background: Acquired immunodeficiency syndrome (AIDS), stemming from human immunodeficiency virus (HIV) infection, persists as a global concern, despite decreased prevalence due to enhanced therapy and preventive measures. Primary central nervous system lymphoma (PCNSL), a non-Hodgkin lymphoma, necessitates prompt brain imaging. However, nonspecific symptoms can lead to delayed diagnosis. Herein, we present a case of HIV-associated primary CNS lymphoma (HIV-PCNSL) characterized by atypical clinical presentation and laboratory findings. Case presentation: We report a case of a 36-year-old male with no medical history presenting with symptoms including fatigue, left leg weakness, hypoglycemia, and loss of consciousness. Diagnostic evaluations revealed multifocal low-density brain changes and the presence of nontyphoidal Salmonella in blood cultures. Subsequent investigations confirmed acquired immunodeficiency syndrome (AIDS) with concurrent human immunodeficiency virus (HIV) infection. Clinical manifestations and laboratory results suggested panhypopituitarism. A stereotactic brain biopsy confirmed primary central nervous system lymphoma (PCNSL). The patient underwent a comprehensive treatment regimen involving Rituximab and high-dose methotrexate for lymphoma, highly active antiretroviral therapy (HAART) for HIV, and hormone replacement therapy for secondary adrenal insufficiency. This integrated approach resulted in tumor size reduction and overall clinical improvement. Conclusions: AIDS may manifest with diverse symptoms, particularly when neurological deficits are evident, prompting consideration of opportunistic brain infections or malignancies. Our case presentation elucidates the clinical rationale and diagnostic trajectory for detecting AIDS in a young man with hypoglycemia and left leg weakness. This underscores not only the atypical manifestations and differential diagnosis of brain lesions in AIDS patients but also advocates for a comprehensive approach.

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Impact of the COVID-19 Pandemic on People Newly Diagnosed with HIV and those Already in -care in Türkiye

Arzu,

Sabri,

Nazlıhan

et al. 2024

CHR

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Background: COVID-19 has inevitably influenced health systems. HIV testing rates have been reduced, and access to antiretroviral treatment has been scaled down. We evaluated the impact of COVID-19 on the management of people living with HIV (PLWH) in Türkiye. Methods: We conducted a cross-sectional study in three tertiary care hospitals. We compared the baseline characteristics at the first visit and viral suppression rates at the 24th week of new HIV diagnoses during the pandemic with those during the previous two years. To observe the effect of the pandemic on people living with HIV who were already in care, we compared the metabolic and clinical parameters like weight, blood pressure, blood lipid levels, fasting glucose levels, and liver and renal function tests, of the same people before and during the pandemic. Results: The first group included 380 cases (127 diagnosed during the pandemic and 253 diagnosed during the previous year). The demographic characteristics were similar. The newly diagnosed PLWH during the pandemic had significantly higher baseline HIV RNA levels (p=0.005), a lower number of clinical visits (p=0.0005), and a lower number of cases with undetectable viral loads at 24 weeks of treatment (p=0.0005) than those diagnosed during the pre-pandemic period. The second group included 261 individuals with a mean follow-up duration of 24.7 (SD± 3.5; min- max 12-144) months. The comparison of laboratory parameters revealed that in the postpandemic period, virologic suppression was maintained at 90.1%, body mass index (p=0,0001), total cholesterol (p=0,0001), and LDL levels (p=0,0001) increased significantly, and creatinine levels decreased significantly (p=0,0001). Conclusion: Our study showed that COVID-19 deteriorated the HIV management of PLHIV. Strengthening the medical infrastructure of basic services for PLWH is critical for future crises.

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Evaluation of the late presentation and associated factors of people living with HIV in Turkey

Cited by 3 publications

References 51 publications

Risk Factors for Late HIV Presentation in Patients Treated at a Single Belgian Reference Centre from 2018 to 2022

Risk Factors for Late HIV Presentation in Patients Treated at a Single Belgian Reference Centre from 2018 to 2022

Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Impact of the COVID-19 Pandemic on People Newly Diagnosed with HIV and those Already in -care in Türkiye

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