期刊
BMC INFECTIOUS DISEASES
卷 20, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s12879-020-05261-7
关键词
HIV; AIDS; Late presentation; Avoidable events; Eastern Europe; HIV testing
资金
- ViiV Healthcare LLC
- Janssen Scientific Affairs
- Janssen RD
- Bristol-Myers Squibb Company
- Merck Sharp Dohme Corp
- Gilead Sciences
- European Union [260694]
- Swiss National Science Foundation [148522]
- Danish National Research Foundation [DNRF126]
- International Cohort Consortium of Infectious Disease (RESPOND)
- Agence Nationale de Recherches sur le SIDA et les Hepatites Virales (ANRS), France
- HIV Monitoring Foundation, The Netherlands
- Augustinus Foundation, Denmark
- European Union Seventh Framework Programme (FP7/2007-2013) under EuroCoord grant [260694]
BackgroundLate presentation (LP), defined as a CD4 count <350/mm(3) or an AIDS-event at HIV-diagnosis, remains a significant problem across Europe. Linking cohort and surveillance data, we assessed the country-specific burden of LP during 2010-2016 and the occurrence of new AIDS events or deaths within 12months of HIV-diagnosis believed to be attributable to LP.MethodsCountry-specific percentages of LP and AIDS-events/death rates (assessed with Poisson regression) observed in The Collaboration of Observational HIV Epidemiological Research Europe (COHERE) and EuroSIDA cohorts, were applied to new HIV-diagnoses reported to the European Centre for Disease Prevention and Control. The estimated number of LP in the whole population was then calculated, as was the number of excess AIDS-events/deaths in the first 12months following HIV-diagnosis assumed to be attributable to LP (difference in estimated events between LP and non-LP).ResultsThirty-nine thousand two hundred four persons were included from the COHERE and EuroSIDA cohorts, of whom 18,967 (48.4%; 95% Confidence Interval [CI] 47.9-48.9) were classified as LP, ranging from 36.9% in Estonia (95%CI 25.2-48.7) and Ukraine (95%CI 30.0-43.8) to 64.2% in Poland (95%CI 57.2-71.3). We estimated a total of >320,000 LP and 12,050 new AIDS-events/deaths attributable to LP during 2010-2016, with the highest estimated numbers of LP and excess AIDS-events/deaths in Eastern Europe. Country-level estimates of excess events ranged from 17 AIDS-events/deaths (95%CI 0-533) in Denmark to 10,357 (95%CI 7768-147,448) in Russia.ConclusionsAcross countries in Europe, the burden of LP was high, with the highest estimated number of LP and excess AIDS-events/deaths being in Eastern Europe. Effective strategies are needed to reduce LP and the attributable morbidity and mortality that could be potentially avoided.
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