Multicenter epidemiological study to describe prevalence of advanced stage disease among newly diagnosed HIV‐infected patients in the Russian Federation

Abstract

Purpose of the study: The proportion of HIV-infected persons diagnosed in an advanced stage of HIV disease (ASH) varies by country from 15 to 30%. Data are lacking on the proportion of new cases diagnosed in this late stage in Russia. The aim of this study was to estimate the proportion of and further characterize patients with ASH among newly diagnosed HIV-1 infected persons in the Russian Federation. Methods: This was a cross-sectional, multicenter, epidemiologic study. Adult HIV-1 patients that were newly diagnosed within 90 days and naïve to highly active antiretroviral therapy were included at twelve centers/regions (Moscow Region, St Petersburg, Leningrad Region, Ufa, Kazan, Ulyanovsk, Volgograd, Yekaterinburg, Kemerovo, Krasnoyarsk, Irkutsk and Vladivostok) of the Russian Federation. ASH was defined as a CD4+ cell count ≤200 cells/mm3. Pairwise, two-tailed comparisons were conducted with an unadjusted 5% significance level. For comparison variables between patients with ASH and all other patients, Pearson's chi-square test was used. Summary of results: 4540 patients were included. The overall proportion of ASH was 16.3% (95% CI; 15.3%, 17.4%). The median plasma HIV-1 RNA was 4.48 (Q1, Q3; 3.81, 5.07) log10 copies/mL. The proportion of patients with CD4+ cell count by categories is presented in Figure 1.ASH was associated with male sex (62.3%), 26-40 and >40 years age groups, rural place of residence (18.9%), only primary and/or basic school education (complete or not complete) (39.4%), unemployment (40.5%), intravenous drug user as mode of HIV-1 transmission (39.5%), patient with clinical signs of immunodeficiency or condition related to HIV/AIDS as reason for primary HIV-1 testing (35.2%), HBV (5.4%), HCV (44.0%) as partly shown in Table 1. Conclusions: The overall prevalence of ASH was 16.3%. At least 9 factors associated with ASH were revealed. Knowledge of these factors is valuable for planning, prevention and post-diagnosis services for HIV-infected patients presenting with advance stage disease