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Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Late presenters working group in COHERE in EuroCoord, Mocroft Amanda, Lundgren Jens, Antinori Andrea, Monforte Antonella d'Arminio, Brännström Johanna, Bonnet Fabrice, Brockmeyer Norbert, Casabona Jordi, Castagna Antonella, Costagliola Dominique, De Wit Stéphane, Fätkenheuer Gerd, Furrer Hansjakob, Jadand Corinne, Johnson Anne, Lazanas Mario, Leport Catherine, Moreno Santiago, Mussini Christina, Obel Niels, Post Frank, Reiss Peter, Sabin Caroline, Skaletz-Rorowski Adriane,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
Volume (Issue) 20(47)
Page(s) 1560 - 1572
Title of proceedings Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
DOI 10.2807/1560-7917.es.2015.20.47.30070

Open Access

URL http://doi.org/10.2807/1560-7917.ES.2015.20.47.30070
Type of Open Access Publisher (Gold Open Access)

Abstract

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrollment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm(3) or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm(3) (interquartile range (IQR) 193-555/mm(3)), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.
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