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

Wójcik-Cichy, Kamila; Jabłonowska, Olga; Piekarska, Anna; Jabłonowska, Elżbieta

doi:10.1080/09540121.2018.1470306

Cited by 20 publications

(8 citation statements)

References 15 publications

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“…Furthermore, according to other studies in Poland and the Netherlands, males were also more prevalent in the late presenters’ population. These results are consistent with our study [ 16 , 17 , 18 ].…”

Section: Discussionsupporting

confidence: 94%

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

et al. 2021

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To control the Human Immunodeficiency Virus (HIV) pandemic, the World Health Organization (WHO) set the 90-90-90 target to be reached by 2020. One major threat to those goals is late presentation, which is defined as an individual presenting a TCD4+ count lower than 350 cells/mm3 or an AIDS-defining event. The present study aims to identify determinants of late presentation in Europe based on the EuResist database with HIV-1 infected patients followed-up between 1981 and 2019. Our study includes clinical and socio-demographic information from 89851 HIV-1 infected patients. Statistical analysis was performed using RStudio and SPSS and a Bayesian network was constructed with the WEKA software to analyze the association between all variables. Among 89,851 HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. Of those, 28,889 patients (50.4%) were late presenters. Older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1 had a higher probability of being late presenters (p < 0.001). Bayesian networks indicated VL, mode of transmission, age and recentness of infection as variables that were directly associated with LP. This study highlights the major determinants associated with late presentation in Europe. This study helps to direct prevention measures for this population.

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Section: Discussionsupporting

confidence: 94%

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

et al. 2021

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“…The results from previous studies showed statistically significant correlation between late presentation and HIV exposure category [6,16,17]. While we did not find this significant correlation in our logistic regression analysis, we did find it in the univariate analysis.…”

Section: Discussioncontrasting

confidence: 83%

Determinants of HIV-1 late presentation in a cohort of Portuguese HIV-1 patients

Miranda

Pingarilho

et al. 2020

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Background: Undiagnosed HIV-1 patients still account for 25% of worldwide HIV patients. Studying late presenters for HIV care may help to identify characteristics of such patients. Objective: The present study aims to identify factors associated with late presentation (LP) and late presentation with advanced disease (LPAD) based on a population of patients followed in a Portuguese hospital between 1984 and 2017. Methods: Sociodemographic and clinical data from infected patients with HIV-1 aged 18 years and older, followed in Egas Moniz Hospital, in Portugal were collected. Results: Of the 907 patients included in this study, 68.7% were males and the median age was 37 years (IQR 30-47). 459 patients (50.6%) were LP and, of these, 284 patients (61.9%) were LPAD. The LP population mostly originated from Portugal and Sub-Saharan Africa (64.4% and 28.8%; p=0.004) and the HIV exposure category mainly heterosexuals and MSM (57.0% and 24.9%; p<0.001). The stage of disease and viral load at diagnosis were significantly associated with both LP and LPAD (p<0.001). Factors associated with LP in the logistic regression included age at diagnosis lower than 30y (aOR 0.34; 0.17-0.68; p=0.002) and origin from Sub-Saharan Africa (aOR 2.24; 1.44-3.50; p<0.001). Conclusion: Late presentation is a major obstacle to halt the HIV epidemic. In this population, the majority of newly diagnosed HIV-infected individuals were late presenters. Our results characterize vulnerable populations that should be frequently tested for HIV. Keywords: HIV-1 infection, Late presentation, Late presentation with advanced disease

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“…However, data from a smaller single‐centre study in Poland showed a very high (63%) incidence of late presentation for HIV infection. Similarly, older individuals and those with a history of active drug use and the heterosexual route of transmission were more likely to present late than MSM . The decrease in the frequency of individuals presenting late and with advanced HIV disease may be associated with greater awareness and a higher frequency of testing , and is reflected in the increasing number of individuals entering care with asymptomatic infection, especially in the MSM population (Fig.…”

Section: Discussionmentioning

confidence: 97%

“…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%

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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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

Cited by 20 publications

References 15 publications

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Determinants of HIV-1 late presentation in a cohort of Portuguese HIV-1 patients

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

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