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- Title
Epidemiology, comorbidities at diagnosis and outcomes associated with HIV late diagnosis from 2010 to 2019 in a Belgian reference centre: A retrospective study.
- Authors
Severin, Simon; Delforge, Marc; De Wit, Stéphane
- Abstract
Objectives: Our objective was to investigate the demographic factors, comorbidities, and outcomes of patients with a late diagnosis (LD) of HIV in a Belgian HIV reference centre. Methods: All patients with HIV who presented for care between 2010 and 2019 were included. They were excluded if time between diagnosis and presentation or first CD4 count exceeded 6 months or if they had previously received antiretroviral therapy (ART). LD was defined as a CD4 cell count ≤350/mm3or an AIDS‐defining event at diagnosis. Data were retrospectively collected and included data on demographic variables, cardiovascular risk factors, comorbidities at diagnosis, first prescribed ART, and outcomes. Logistic regression was used to determine factors associated with LD. Results: Of 1078 patients, 427 (39.6%) were LD. In multivariable analysis, the following factors were associated with LD: non‐homosexual transmission route, being born in Sub‐Saharan Africa (SSA), and age ≥35 years. Prevalence at diagnosis of malignancies, diabetes, and cardiovascular diseases did not differ between non‐LD and LD, whereas renal impairment was more frequent in LD. In univariable analysis, high‐density lipoprotein (HDL) cholesterol <40 mg/dL and estimated glomerular filtration rate <60 ml/min were associated with LD; in multivariable analysis, only HDL cholesterol <40 mg/dL was associated. Patients with LD experienced more adverse events leading to a switch in ART, virological failure, and death during follow‐up. Conclusion: LD remains common in our centre, especially in non‐homosexual patients and those born in SSA. Although not associated with an important burden of comorbidities at diagnosis, it still results in poorer outcomes, emphasizing the need to expand coverage and access to HIV testing.
- Subjects
BELGIUM; HIV infection epidemiology; DIAGNOSIS of HIV infections; DELAYED diagnosis; KRUSKAL-Wallis Test; STATISTICS; HDL cholesterol; GLOMERULAR filtration rate; CARDIOVASCULAR diseases risk factors; CONFIDENCE intervals; TIME; MULTIVARIATE analysis; LOG-rank test; RETROSPECTIVE studies; FISHER exact test; MANN Whitney U Test; TREATMENT effectiveness; BELGIANS; KAPLAN-Meier estimator; DESCRIPTIVE statistics; CHI-squared test; SURVIVAL analysis (Biometry); INFECTIOUS disease transmission; LOGISTIC regression analysis; DATA analysis software; ODDS ratio; COMORBIDITY
- Publication
HIV Medicine, 2022, Vol 23, Issue 11, p1184
- ISSN
1464-2662
- Publication type
Article
- DOI
10.1111/hiv.13440