Late presenters among newly diagnosed HIV-infected in Poland in 2006-2008

Pyziak-Kowalska, Karolina; Dusza, Marta; Mularska, E.; Kalinowska-Nowak, Anna; Jabłonowska, Elżbieta; Barałkiewicz, Grażyna; Bander, Dorota; Podlasin, Regina; Kubicka, Joanna

doi:10.5114/hivar.2017.72025

Cited by 4 publications

(3 citation statements)

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“…The first Polish data collected from several centres for 1100 newly diagnosed HIV‐infected Polish patients in the 2006–2008 period showed that almost 50% were late presenters, with a median CD4 count at diagnosis of 355 cells/μL. Older age and male PWID were risk factors for delayed care entry . However, data from a smaller single‐centre study in Poland showed a very high (63%) incidence of late presentation for HIV infection.…”

Section: Discussionmentioning

confidence: 99%

“…This has been associated with improved prognosis and a decrease in mortality among HIV‐infected patients. Delayed HIV diagnosis and late care entry, linked to late presentation either with diagnosed AIDS or with low CD4 counts, remain major challenges for the control of the HIV/AIDS epidemic, with single‐centre data indicating that 50 to 63% of individuals were linked to care with either AIDS or a CD4 count < 350 cells/μL, despite expansion of test and treat efforts in Poland .…”

Section: Introductionmentioning

confidence: 99%

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Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

et al. 2019

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Introduction Delay in HIV diagnosis and consequently late care entry with low CD4 counts remain a major challenge for the control of the HIV/AIDS epidemic. The aim of this study was to analyse the evolution of characteristics of the HIV epidemic in Poland. Methods Cross‐sectional data were collected for 3972 HIV‐infected patients followed up in 14 of 17 Polish HIV treatment centres in the years 2000–2015. Clinical data were analysed and factors associated with late presentation (baseline CD4 count < 350 cells/μL or history of AIDS‐defining illness) and advanced HIV disease (baseline CD4 count < 200 cells/μL or history of AIDS) were identified. Results The majority (57.6%) of patients entered care late, while 35.6% presented with advanced HIV disease. The odds of being linked to care late or with advanced HIV disease increased consistently across age categories, increasing from 2.55 [95% confidence interval (CI) 1.46–4.47] for late presentation and 3.13 (95% CI 1.49–6.58) for advanced disease for the 21–30‐year‐old category to 5.2 (95% CI 1.94–14.04) and 8.15 (95% CI 2.88–23.01), respectively, for individuals > 60 years of age. Increased risks of late entry and advanced HIV disease were also observed for injecting drug users [adjusted odds ratio (aOR) 1.74 (95% CI 1.16–2.60) and 1.55 (95% CI 1.05–2.30), respectively], with lower aOR associated with the men who have sex with men transmission route [aOR 0.3 (95% CI 0.31–0.59) and 0.39 (95% CI 0.29–0.53), respectively]. The frequencies of cases in which patients were linked to care late and with advanced HIV disease decreased over time from 67.6% (2000) to 53.5% (2015) (P < 0.0001) and from 43.5% (2000) to 28.4% (2015) (P = 0.001), respectively. Conclusions Despite improvements over time, most patients diagnosed with HIV infection entered care late, with a third presenting with advanced HIV disease. Late care entry remains common among people who inject drugs and heterosexual groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

et al. 2019

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“…In a number of countries, including Poland, as many as 45–60% of patients are diagnosed with HIV/AIDS very late and at the stage of full-blown AIDS, usually with severe immunodeficiency and a CD4 T-lymphocyte count below 350 cells/mm 3 (late presenters). This requires quick and complex diagnostics and the fastest possible introduction of cART therapy [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Neurological Disorders of Patients Living with HIV Hospitalized in Infectious Departments of the Specialist Hospital in Lower Silesia in Poland

Janocha-Litwin

Simon

2022

Healthcare

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Background and Objectives: Central nervous system (CNS) disorders are estimated to occur in approximately 10–20% of people living with HIV (PLWH). They are more commonly observed in newly diagnosed patients and in previously untreated patients or those refusing to undergo antiretroviral treatment. CNS diseases can also be the first manifestation of HIV/AIDS infection. The most common HIV-related central nervous system diseases (CNS-D) are CNS toxoplasmosis, CNS cryptococcosis, progressive multifocal leukoencephalopathy (PML), and HIV-associated encephalopathy treated as a neurocognitive disorder. Materials and Methods: A retrospective analysis of available medical records was performed on 476 patients hospitalised over a period from 2016 to 2021 and diagnosed with HIV/AIDS infection at the department of infectious diseases at the Provincial Specialist Hospital in Wroclaw. An additional criterion for selecting patients for the analysis was the performance of head imaging using computed tomography or magnetic resonance imaging on prospective patients. Results: Neurotoxoplasmosis, neurocryptococcosis, progressive multifocal leukoencephalopathy (PML), and neurosyphilis were the most common CNS diseases among the analysed group of patients. Based on radiological descriptions, other abnormalities, such as vascular changes or cortical and subcortical atrophy of multifactorial origin, not exclusively related to HIV infection, were also frequently observed. The most common neurological symptoms reported in the study group were headaches, limb paresis, and gait and balance disturbance. Conclusions: The clinical picture and epidemiology of neurological manifestations in the group of HIV-infected patients under assessment were similar to the results of other authors. Given the current epidemiological situation, diagnosis for HIV infection should be considered in patients admitted to neurological departments.

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HIV-1 Infection Trends in Lower Silesia (2010–2020): A Comparative Analysis of Women and Men and the Urgent Need for Enhanced Screening

Kozieł,

Cieślik,

Janek

et al. 2024

IJWH

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Introduction Human Immunodeficiency Virus (HIV) remains a major global health issue. In Poland, men represent 79% of the HIV-infected population, but the proportion of women diagnosed has been increasing. This study examines the clinical condition of newly diagnosed HIV-1 patients in Lower Silesia at three key points: 2010, 2016, and 2020, to understand infection dynamics and improve regional screening and prevention efforts. Objective The objective of the study is to compare the clinical condition of newly diagnosed women and men with HIV-1 in Lower Silesia at three time points in order to identify trends and differences that can inform targeted public health strategies. Methods A retrospective analysis of medical records from the HIV clinic in Wroclaw was conducted for the years mentioned. The dataset included demographic information, transmission routes, clinical status, and co-infections. Results The study included 202 patients, of whom 27 were women. Heterosexual transmission was the primary route among women (2010/2016/2020 – 44.44%/57.14%/90.91%), while men predominantly acquired HIV-1 through homosexual contact (2010/2016/2020 – 52.94%/80.82%/75%). A significant decrease in infections from intravenous drug use was observed among men ( Chi 2 = 24.85, df = 2, p < 0.001). Women consistently had lower CD4+ T cell counts, with a median (Q1, Q3) of 250 (108–288), significantly lower than men’s 431 (280–550) (Mann–Whitney U -test: z = 4.23, p < 0.001). Women were also more frequently diagnosed as late presenters (OR: 6.07, 95% CI (2.34–15.82)). Conclusion This study identifies significant gender disparities in HIV-1 diagnosis in Lower Silesia, with women being six times more likely to be diagnosed as late presenters. This highlights the necessity for enhanced and targeted public health interventions, particularly within the context of antenatal care.

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Late presenters among newly diagnosed HIV-infected in Poland in 2006-2008

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.

Cited by 4 publications

References 23 publications

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

Long‐term trends in HIV care entry: over 15 years of clinical experience from Poland

Neurological Disorders of Patients Living with HIV Hospitalized in Infectious Departments of the Specialist Hospital in Lower Silesia in Poland

HIV-1 Infection Trends in Lower Silesia (2010–2020): A Comparative Analysis of Women and Men and the Urgent Need for Enhanced Screening

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