Late presentation to HIV testing is overestimated when based on the consensus definition
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| Názov: | Late presentation to HIV testing is overestimated when based on the consensus definition |
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| Autori: | Sasse, André, Florence, E, Pharris, A, De Wit, Stéphane, Lacor, P, Van Beckhoven, D, Deblonde, J, Delforge, Marie-Luce, Fransen, Katrien, Goffard, Jean-Christophe, Legrand, Jean Claude, Moutschen, M, Pierard, Denis, Ruelle, J, Vaira, Dolores, Vandercam, B, Van Ranst, Marc, Van Wijngaerden, Eric, Vandekerckhove, Linos, Verhofstede, C, Belgian Research AIDS & HIV Consortium (BREACH) |
| Prispievatelia: | Clinical sciences, FORMER_Microbiology and Infection Control, Internal Medicine, Supporting clinical sciences, Clinical Biology, Department of Bio-engineering Sciences |
| Zdroj: | HIV Med HIV medicine HIV MEDICINE |
| Informácie o vydavateľovi: | Wiley, 2015. |
| Rok vydania: | 2015 |
| Predmety: | DYNAMICS, Male, Consensus, Delayed Diagnosis, Short Communication, late diagnosis, men who have sex with men, 4202 Epidemiology, HIV Infections, DIAGNOSIS, 03 medical and health sciences, 0302 clinical medicine, Belgium, Risk Factors, Virology, SEROCONVERSION, INFECTION, risk factors, Belgian Research AIDS & HIV Consortium (BREACH), Humans, Homosexuality, Male, Pathologie maladies infectieuses, Belgium/epidemiology, late presentation, Science & Technology, 3202 Clinical sciences, HIV, 1103 Clinical Sciences, Sciences bio-médicales et agricoles, CARE, testing, CD4 Lymphocyte Count, 3. Good health, AIDS, HIV Infections/diagnosis, consensus definition, Homosexuality, Male/statistics & numerical data, Infectious Diseases, Life Sciences & Biomedicine, Delayed Diagnosis/statistics & numerical data |
| Popis: | ObjectivesIn 2011, a consensus was reached defining “late presenters” (LPs) as individuals presenting for care with a CD4 count AIDS‐defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account.MethodsCase surveillance data for newly diagnosed patients in Belgium in 1998–2012 were analysed, including CD4 count at diagnosis, the presence of AIDS‐defining events, and recent infections (LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as “nonlate” if infections were reported as recent.ResultsA total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012.ConclusionsThis study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. |
| Druh dokumentu: | Article Other literature type |
| Popis súboru: | 1 full-text file(s): application/pdf; application/pdf |
| Jazyk: | English |
| ISSN: | 1468-1293 1464-2662 |
| DOI: | 10.1111/hiv.12292 |
| Prístupová URL adresa: | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/hiv.12292 https://pubmed.ncbi.nlm.nih.gov/26222266 http://dspace.itg.be/handle/10390/8791 https://onlinelibrary.wiley.com/doi/full/10.1111/hiv.12292 https://biblio.ugent.be/publication/7275064/file/8066405.pdf http://europepmc.org/articles/PMC5034831 https://researchportal.vub.be/en/publications/late-presentation-to-hiv-testing-is-overestimated-when-based-on-t https://core.ac.uk/display/77581473 https://lirias.kuleuven.be/handle/123456789/523129 https://doi.org/10.1111/hiv.12292 http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/224471 https://biblio.vub.ac.be/vubir/late-presentation-to-hiv-testing-is-overestimated-when-based-on-the-consensus-definition(3053687b-d9de-4907-92ae-28e73d35b524).html https://biblio.ugent.be/publication/7275064/file/8066405 https://biblio.ugent.be/publication/7275064 http://doi.org/10.1111/hiv.12292 http://hdl.handle.net/1854/LU-7275064 |
| Rights: | CC BY NC ND |
| Prístupové číslo: | edsair.doi.dedup.....cdee0fcc85701d00cea64db37679a071 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | ObjectivesIn 2011, a consensus was reached defining “late presenters” (LPs) as individuals presenting for care with a CD4 count AIDS‐defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account.MethodsCase surveillance data for newly diagnosed patients in Belgium in 1998–2012 were analysed, including CD4 count at diagnosis, the presence of AIDS‐defining events, and recent infections (LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as “nonlate” if infections were reported as recent.ResultsA total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012.ConclusionsThis study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. |
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| ISSN: | 14681293 14642662 |
| DOI: | 10.1111/hiv.12292 |