Late presenters among newly diagnosed HIV-infected in Poland in 2006-2008

Abstract

Introduction: Assessment of incidence and factors associated with late vs. early human immunodeficiency virus (HIV) diagnosis among newly diagnosed patients referred to HIV treatment centres in Poland in the years 2006-2008. Material and methods: Retrospective analysis of medical records of patients reported from eight regional centres for HIV treatment in Poland in years 2006-2008 was conducted. The study population consisted of 1132 HIV-infected patients newly diagnosed with HIV infection, aged 17 years up. To describe characteristics of this group of patients in terms of clinical and immunological presentation multivariate regression analysis of demographic and epidemiology data including: sex, age, mode of transmission, CD4 T cell count, and viral load at the time of diagnosis was performed. Results: Among 1132 patients included in the study 564 (49.8%) were late presenters (LP) according to European consensus definition. In multivariate logistic analysis including sex, age and route of infection, as independent factors, age (OR = 1.06), intravenous drug use (OR = 2.17 for IVDU vs. MSM), and heterosexuality (OR = 2.07 for Hx vs. MSM) were risk factors for late testing. The same factors were predictors of advanced HIV disease, as well as unknown route of infection (OR = 1.77; p < 0.05). However, multivariate regression analysis revealed that only advanced age was an independent factor influencing lower CD4 T cell count and late presentation (OR = 1.02 per 1 year of age, p < 0.001). Conclusions: Nearly 50% of patients were diagnosed after the optimal time for antiretroviral treatment initiation, according to actual European and Polish guidelines. These results strongly point out the necessity of further encouragement toward more frequent and earlier HIV testing.