HIV2 late presenters in an infectious disease ward: six years’ experience

Abstract

Purpose of the study: About a third of HIV-infected patients in Europe present for care late in their disease. In 2010 a consensus was reached for a definition of late presentation, providing a new tool for research and acting. With regard to HIV2 infection this population has never been characterized. Methods: Retrospective analysis of the clinical records of all the HIV2-infected patients who meet the inclusion criteria (those defined by the European Late Presenter Consensus working group: Late presentation of HIV infection: a consensus definition 1) admitted to our ward between January 2006 and December 2011. The patients were characterized according to epidemiological, clinical and immunologic status and outcome. Summary of results: During the period analyzed, 15 HIV2 patients were late presenters. The mean age of the patients was 48 years old (although 53% were older than 50 years); 8 (53%) were men; 11 (73%) were of African origin. Heterosexual transmission was reported in three of the patients, in the remainder the transmission mode was not available. The mean TCD4 cell was 188 (range 27-339), with 8 (53%) with a CD4 count below 200 cells. Twelve (80%) of the patients fulfilled AIDS criteria. There were 3 deaths, corresponding to a mortality rate of 20%. The cause of death was disseminated tuberculosis in two cases and non-Hodgkin's lymphoma in the third case. Conclusions: Most late presenters with HIV2 infection are of African origin, there is an even distribution between genders, their mean age is around 50 years old, more than half had a CD4 cell count below 200 and there was a 20% mortality rate. These patients pose challenges at various levels: their mortality rate is much higher than in the general HIV-infected population and they are diagnosed very late, leading to a disproportionate increase in risk of transmission, morbidity and mortality.