HIV infection stage at diagnosis and epidemiological features of late presentation

Abstract

Late presentation of HIV‐infected individuals is gaining attention because of the negative impact on the patient and the society at a whole. In January 2011 the European Late Presenter Consensus working group published a consensus definition of “late presentation” and asked researchers to implement it. Objective: to identify presentation stage of HIV‐infected individuals at diagnosis at the German Hospital in Buenos Aires, Argentina, and describe epidemiological features of them. The German Hospital is an acute care community hospital that assists around 600 000 out‐patient consultations per year. We examine the clinical reports of all our HIV patients, diagnosed 1984–2011, and grouped them as “late” or “not late” presentation according their status following the consensus definition criteria. We also looked for data, such as age, sex and year of diagnosis, that could differ between the groups. We reviewed 284 clinical records, 7 of which were excluded because of lack of data; 105 belonged to last century records. Median age for 1984–1999 group: 32 (16–73), for 2000–2010 group: 40 (180–78). 77% of the first group were men, and 88% of the second one. 1984–1999 1984–1999 No late 1984–1999 Late 1984–1999 % (Late/total) 1984–1999 Total 2000–2010 No late 2000–2010 Late 2000–2010 % (Late/total) 2000–2010 Total Total 61 44 42 105 102 70 40,7 172 Age group <20 6 0 0 6 3 3 50 6 21–30 25 13 34,2 38 33 7 17,5 40 31–40 14 15 51,7 29 35 18 34 53 41–50 10 12 54,5 22 16 18 52,9 34 51–60 6 1 14,3 7 9 17 65,4 26 61–70 0 2 100 2 6 4 40 10 >71 0 1 100 1 0 3 100 3 Sex Female 18 6 25 24 8 8 38 21 Male 43 38 47 81 62 62 41 151 In 55,5% of the 1984–1999 group diagnosis was due to an opportunistic infection, whereas the same applied to only 32,8% of the 2000–2010 group. In both groups there were a high proportion of male, due to the population profile of our hospital. The most frequent reason for testing was screening, but there is still a high number of late diagnosis and OI as first sign of the infection. Younger people are more aware of the need of testing. Female have the advantage of being tested when planning or becoming pregnant. We could not find statistical differences comparing data of both centuries. Forty percent of infections were diagnosed in a “not late” stage, but that was more evident in younger people. People in general and physicians in particular should be more aware of HIV in elderly people.