Abstract
Late presentation for HIV care is a major issue and the cause of higher morbidity, mortality and transmission. In this regard, we analyzed the characteristics of patients presenting for care at our center from January 2006 to July 2017 (n = 687). The majority of the studied population was of African origin (54.3%) with heterosexual women representing the main group (n = 292; 42.5%). 44% of the patients were late presenters (LP) (presenting for care with CD4 T cells <350/mm3 or an AIDS defining event) and 24% were late presenters with advanced disease (LP-AD) (presenting for care with CD4 T cells <200/mm3 or an AIDS defining event). A very high risk of being LP and LP-AD was associated with Sub-Saharan origin (OR 3.4 and 2.6 respectively). Other factors independently associated with LP or LP-AD were age (OR 1.3), male gender (OR 2.0 and 1.5 respectively) and heterosexual route of transmission (OR 2.4 and 2.3 respectively). A significant increase in HIV screening without forgetting those groups would contribute to earlier HIV diagnosis, a key element to end the HIV epidemic. To achieve this goal, addressing the specific hurdles to HIV testing in the migrant population is critical.
Highlights
Since a few years, the 90-90-90 target has become a central column of the worldwide pursuit to end the AIDS epidemic
Of 759 patients who presented for care at the Liege University Hospital (Belgium) between the 1st January 2006 and 31 July 2017, 68 were excluded because there was evidence that these people had been previously followed at another center or treated before
Current guidelines indicate that Antiretroviral therapy (ART) should always be recommended irrespective of the CD4 T cell count, but the lower the CD4 T count, the greater the urgency to start ART immediately[17]
Summary
The 90-90-90 target has become a central column of the worldwide pursuit to end the AIDS epidemic. Antiretroviral therapy (ART) is recommended for all those with HIV infection in order to prevent AIDS-related illness and to decrease the risk of transmission. Unless ART is started early, a large majority of latent viruses which constitute the HIV reservoir carries mutations that render infected cells insensitive to cytotoxic T lymphocytes (CTL)[13]. Because of its many negative consequences for infected individuals and HIV transmission, it is critical to identify factors associated with late presentation for HIV care. The identification of those factors could improve the effectiveness of HIV testing strategies with a focus on susceptible and possibly neglected groups. It highlighted that there are major www.nature.com/scientificreports/
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call