The high incidence of late presenters for HIV/AIDS infection in the Lodz province, Poland in the years 2009–2016: we are still far from the UNAIDS 90% target

Abstract

ABSTRACTThe present study retrospectively analyses the prevalence of late diagnosis in patients with newly-diagnosed HIV infection in Lodz, Poland from January 2009 to December 2016, and assesses the predictive factors associated with late presenters. Late presentation is defined as a diagnosis of HIV with a CD4 count<350 cells/μL, or the occurrence of an AIDS- defining event, regardless of the CD4 cell count. Two hundred and fifty-nine (62.86%) patients were late presenters, 178 of whom (68.72%) were advanced late presenters (CD4 cell count below 200 cells/μL). Multivariate factors associated with late HIV presentation included referral from physician for HIV testing (OR: 3.95, 95% CI 2.42–6.46), older age (OR: 1.81, 95% CI: 1.38–2.38) and route of HIV transmission. Heterosexual patients (OR 1.98, 95% CI: 1.01–3.90), active drug users (OR: 3.49, 95% CI: 1.63–7.48) and patients who did not report the route of transmission (OR: 4.29, 95%: CI 1.45–12.62) were more likely to present late than MSM subjects. In conclusion, the majority of HIV-infected patients are still diagnosed late. There is a need for expanded testing not only in MSM group, in which HIV prevalence is the highest, but also in intravenous drug users, or among subjects who are heterosexual or from a higher age group.