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- Title
Delayed diagnosis of HIV infection and late initiation of antiretroviral therapy in the Swiss HIV Cohort Study.
- Authors
Wolbers, M.; Bucher, H.C.; Furrer, H.; Rickenbach, M.; Cavassini, M.; Weber, R.; Schmid, P.; Bernasconi, E.; Hirschel, B.; Battegay, M.
- Abstract
Objectives To investigate delayed HIV diagnosis and late initiation of antiretroviral therapy (ART) in the Swiss HIV Cohort Study. Methods Two sub-populations were included: 1915 patients with HIV diagnosis from 1998 to 2007 and within 3 months of cohort registration (group A), and 1730 treatment-naïve patients with CD4≥200 cells/μL before their second cohort visit (group B). In group A, predictors for low initial CD4 cell counts were examined with a median regression. In group B, we studied predictors for CD4<200 cells/μL without ART despite cohort follow-up. Results Median initial CD4 cell count in group A was 331 cells/μL; 31% and 10% were <200 and <50 cells/μL, respectively. Risk factors for low CD4 count were age and non-White race. Homosexual transmission, intravenous drug use and living alone were protective. In group B, 30% initiated ART with CD4≥200 cells/μL; 18% and 2% dropped to CD4 <200 and <50 cells/μL without ART, respectively. Sub-Saharan origin was associated with lower probability of CD4 <200 cells/μL without ART during follow-up. Median CD4 count at ART initiation was 207 and 253 cells/μL in groups A and B, respectively. Conclusions CD4<200 cells/μL and, particularly, CD4<50 cells/μL before starting ART are predominantly caused by late presentation. Earlier HIV diagnosis is paramount.
- Subjects
COHORT analysis; DIAGNOSIS of HIV infections; HIV infections; HIV-positive persons; ANTIVIRAL agents
- Publication
HIV Medicine, 2008, Vol 9, Issue 6, p397
- ISSN
1464-2662
- Publication type
Article
- DOI
10.1111/j.1468-1293.2008.00566.x