E Jabłonowska1, B Szetela2, M Bielecki3, A Horban4, M Bociąga-Jasik5, E Mularska6, M Hlebowicz7, A Olczak8, M Parczewski9, A Grzeszczuk10, D Bielec11, A Cybula12, A Kocbach-Przudzik13, M Ankiersztejn-Bartczak14, J D Kowalska15. 1. Department of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland. 2. Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroclaw Medical University, Wroclaw, Poland. 3. Department of Psychology, SWPS University of Social Sciences and Humanities, Warszawa, Poland. 4. Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Warsaw, Poland. 5. Department of Infectious Diseases, Jagiellonian University Medical College, Cracow, Poland. 6. Outpatient Clinic for AIDS Diagnostics and Therapy Specialistic Hospital, Chorzow, Poland. 7. Department of Infectious Diseases, Gdansk Medical University, Gdansk, Poland. 8. Faculty of Medicine, Department of Infectious Diseases and Hepatology Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland. 9. Department of Infectious and Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland. 10. Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland. 11. Department of Infectious Diseases, Medical University in Lublin, Lublin, Poland. 12. Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland. 13. Clinical Division of Infectious Diseases, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland. 14. Foundation of Social Education (FES), Warsaw, Poland. 15. Department of Adults' Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
Abstract
OBJECTIVES: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. METHODS: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. RESULTS: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). CONCLUSIONS: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.
OBJECTIVES: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. METHODS: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. RESULTS: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). CONCLUSIONS: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.
Authors: Karol Serwin; Anna Urbańska; Kaja Scheibe; Magdalena Witak-Jędra; Maria Jankowska; Maria Hlebowicz; Monika Bociąga-Jasik; Anna Kalinowska-Nowak; Martyna Biała; Hubert Ciepłucha; Władysław Łojewski; Anita Olczak; Elżbieta Jabłonowska; Aldona Kowalczuk-Kot; Błażej Rozpłochowski; Adam Witor; Miłosz Parczewski Journal: Sci Rep Date: 2021-08-16 Impact factor: 4.996