Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico.
Salud Publica Mex. 2012 Oct;54(5):506-14. doi: 10.1590/s0036-36342012000500007.
To evaluate the prevalence of late HIV diagnosis (CD4<200 cell/mm³) in an HIV clinic in Mexico City between 2001-2008, to assess changes in this prevalence across the study period, and to determine the risk factors associated to late testing (LT).
Cross-sectional analysis including all patients recently diagnosed as HIV. We estimated the proportion of LT patients and compared demographic characteristics between those and all other. We determine the risk factors associated to LT using logistic regression methods.
Sixty one percent of LT patients present when are diagnosed for the first time. The prevalence did not decrease between 2001 and 2008 (p=0.37). Older age (OR: 2.4; 95%CI 1.2-4.7), unemployment (OR: 1.75; 95%CI 1.12-2.75) and less than nine years of education (OR: 2.44; 95%CI 1.37-4.33) were independently associated to LT, in a multivariate analysis.
LT has high prevalence in Mexico, this impact on antiretroviral effectiveness and perhaps on HIV transmission. Policies for HIV-prevention in Mexico need to be modified to reduce LT prevalence including more aggressive strategies of testing.
评估 2001-2008 年期间墨西哥城一家 HIV 诊所中晚期 HIV 诊断（CD4<200 细胞/mm³）的流行率，评估该研究期间这一流行率的变化，并确定与晚期检测（LT）相关的危险因素。
包括所有近期诊断为 HIV 的患者在内的横断面分析。我们估计了 LT 患者的比例，并比较了 LT 患者与其他所有患者的人口统计学特征。我们使用逻辑回归方法确定与 LT 相关的危险因素。
61%的 LT 患者在首次诊断时就出现了这种情况。2001 年至 2008 年间，这种流行率并没有下降（p=0.37）。年龄较大（OR：2.4；95%CI 1.2-4.7）、失业（OR：1.75；95%CI 1.12-2.75）和受教育年限少于九年（OR：2.44；95%CI 1.37-4.33）在多变量分析中与 LT 独立相关。
墨西哥的 LT 患病率很高，这对抗病毒治疗效果，甚至对 HIV 传播都有影响。墨西哥的 HIV 预防政策需要进行修改，以降低 LT 的流行率，包括采取更积极的检测策略。
