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Inicio Medicina Clínica (English Edition) Profile of new HIV diagnoses and risk factors associated with late diagnosis in ...
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Vol. 155. Issue 11.
Pages 482-487 (December 2020)
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Vol. 155. Issue 11.
Pages 482-487 (December 2020)
Original article
Profile of new HIV diagnoses and risk factors associated with late diagnosis in a specialized outpatient clinic during the 2014–2018 period
Perfil de los nuevos diagnósticos de VIH y factores de riesgo asociados al diagnóstico tardío en una consulta especializada durante el periodo 2014-2018
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Zaira R. Palacios-Baenaa,
Corresponding author
, Miguel Martín-Ortegaa, M. José Ríos-Villegasa,b
a Unidad de Gestión de Enfermedades Infecciosas, Microbiología y Medicina Preventiva. Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
b Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
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Tables (4)
Table 1. Epidemiological, clinical, and laboratory characteristics of new HIV diagnoses analyzed during the study period.
Table 2. Epidemiological, clinical, and laboratory characteristics of patients with a late diagnosis (LD).
Table 3. Univariate and multivariate analysis of the risk factors associated with a late diagnosis.
Table 4. Univariate and multivariate analysis of the risk factors associated with a late diagnosis with an advanced disease.
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Abstract
Introduction

Late diagnosis (LD) of HIV infection is associated with an increase in morbidity and mortality and transmissibility. The aim of this study was to define the clinical characteristics of new diagnoses and clarify the risk factors (RF) associated with LD with or without advanced disease (AD) between 2014 and 2018.

Methods

Patients with a new diagnosis of HIV infection treated in a specialized outpatient clinic of a third level hospital were included. LD with or without AD was defined as aCD4 count <350cells/mm3 or CD4 <200cells/mm3 respectively and/or the presence of any AIDS condition on diagnosis. An analysis was performed using binary logistic regression to analyze the RF associated with LD and the AD.

Results

Of the 205 new diagnoses, 102 (50%) were LD. Age ≥32 years [(OR, 95% CI); 2.92 (1.52–5.59)], transmission different than in men who have sex with men [3.39 (1.56–7.34)] and hospitalization on diagnosis [9.68 (2.63–35.68)] were RF associated with LD. On the other hand, having a concomitant sexually transmitted disease (STD) [.37 (.17–.77)] was associated with an early diagnosis. The results were similar when analysing the LD with AD except for the STD.

Conclusion

Knowledge of the clinical and epidemiological characteristics of new diagnoses of HIV infection and of the RF for LD with or without AD provides an opportunity for early diagnosis and to reduce transmissibility.

Keywords:
Late diagnosis
HIV
Risk factors
Advanced disease
AIDS
Resumen
Introducción

El diagnóstico tardío (DT) de la infección por el VIH se asocia con un aumento de su morbimortalidad y su transmisibilidad. El objetivo de este estudio fue definir las características clínicas de los nuevos diagnósticos y clarificar los factores de riesgo (FR) asociados al DT con o sin enfermedad avanzada (EA) entre el año 2014 y 2018.

Métodos

Se incluyeron a los pacientes con nuevo diagnóstico de infección por el VIH atendidos en una consulta especializada de un hospital de tercer nivel. El DT con o sin EA se definió como el recuento de CD4 < 350 cel/mm3 o CD4 < 200 cel/mm3 respectivamente y/o condición definitoria de sida al diagnóstico. Se realizó un análisis mediante regresión logística binaria para analizar los FR asociados al DT y a la EA.

Resultados

De los 205 nuevos diagnósticos, 102 (50%) fueron DT. La edad ≥32 años [(OR, IC95%); 2,92 (1,52-5,59)], la transmisión distinta a la de hombres que tienen sexo con hombres [3,39 (1,56-7,34)] y la hospitalización en el diagnóstico [9,68 (2,63-35,68)] fueron FR asociados al DT. Por otro lado, tener una enfermedad de transmisión sexual (ETS) concomitante [0,37 (0,17-0,77)] se asoció con un diagnóstico precoz. Los resultados fueron similares al analizar el DT con EA excepto para la ETS.

Conclusión

El conocimiento de las características clínicas y epidemiológicas de los nuevos diagnósticos de infección por el VIH y de los FR para el DT con o sin EA constituyen una oportunidad para el diagnóstico precoz y para disminuir la transmisibilidad.

Palabras clave:
Diagnóstico tardío
VIH
Factores de riesgo
Enfermedad avanzada
Sida

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