Repositori URV

Identificador: imarina:9296786

Handle: https://hdl.handle.net/20.500.11797/imarina9296786

Autors:
Berenguer, JuanBohlius, JuliaBouteloup, VincentBucher, HeinerCozzi-Lepri, AlessandroDabis, FrancoisMonforte, Antonella d'ArminioDavies, Mary-Annedel Amo, JuliaDorrucci, MariaDunn, DavidEgger, MatthiasFurrer, HansjakobGuiguet, MargueriteGrabar, SophieJudd, AliKirk, OleLambotte, OlivierLeroy, ValerianeLodi, SaraMatheron, SophieMeyer, LaurenceMiro, Jose M.Mocroft, AmandaMonge, SusanaNakagawa, FumiyoParedes, RogerPhillips, AndrewPuoti, MassimoSchomaker, MichaelSmit, ColetteSterne, JonathanThiebaut, RodolpheThorne, ClaireTorti, Carlovan der Valk, MarcWittkop, LindaWyss, NatashaLate Presenters Working Grp COHERE

Resum:
Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged >= 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrolment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm(3) or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm(3) (interquartile range (IQR) 193-555/mm(3)), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.