Late presentation of HIV infection in northern Greece: prevalence and correlates, 20002010
Abstract number: P2175
Metallidis S., Pilalas D., Skoura L., Antoniadou Z.A., Tsachouridou O., Haidich A.B., Chrysanthidis T., Bakaimi I., Magaliou E., Margariti A., Nikolaidis I., Kollaras P., Malisiovas N., Nikolaidis P.
Objectives: To assess the extent of late presentation for HIV care in North Greece during the period 20002010 and to explore correlations aiming to provide guidance for future interventions.
Methods: HIV infected patients with no prior history of HIV care at presentation and with a CD4 T-cell count within 3 months from the first confirmatory Western blot result were eligible for this study. Epidemiological and laboratory data were retrieved from the database of the AHEPA University Hospital HIV clinic which provides healthcare for the majority of HIV infected individuals in North Greece. Further clinical information were pursued through review of medical files. Any patient presenting with less than 350 CD4 T-cells or with an AIDS-defining event was classified as late presenter as defined by the European Late Presenter consensus working group. Advanced HIV disease was defined accordingly. Time trends in CD4 T-cell count at presentation during the past decade were evaluated and logistic regression models were applied in order to assess risk factors linked to late presentation and advanced HIV disease.
Results: The status at presentation was evaluated for 631 eligible HIV infected individuals. Overall, the proportion of late presentation was estimated to be 52.5% (95% CI:48.6%-56.4%), while the proportion of advanced HIV disease was 31.2% (95% CI:27.6%-34.8%). The CD4 T-cell count at presentation improved over the past decade (p < 0.001) and time trends were consistent with a reduction in the incidence of late presentation and advanced HIV disease in our study population (p < 0.001). Risk factors associated with late presentation in multivariable logistic regression were: intravenous drug use (OR: 2.2, 95% CI:0.984.9, p = 0.057), heterosexual HIV transmission (OR:1.48 95% CI:0.952.3, p = 0.086), origin other than greek (OR:1.65 95% CI:0.932.93, p = 0.088), age at diagnosis per 10 years increase (OR:1.34, 95% CI:1.161.55, p < 0.001) and year of diagnosis (OR: 0.9, 95% CI:0.850.95, p < 0.001).
Conclusions: Despite the trend for improvement, a significant proportion of newly-diagnosed HIV infected patients presents late for care. Targeted interventions with focus on social groups at risk such as the elderly, the intravenous drug users and the immigrants are mandated.
|Session name:||Abstracts of 21st ECCMID / 27th ICC|
|Location:||Milan, Italy, 7 - 10 May 2011|
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