Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Department of Epidemiology, Robert Stempel College of Public Health and Social Work; Research Center in Minority Institutions (RCMI); Florida International University, Miami, FL, USA.
AIDS Rev. 2022 Mar 1;24(1):32-40. doi: 10.24875/AIDSRev.21000007.
Timely HIV diagnosis is critical to minimizing transmission events. We sought to estimate the meantime from HIV infection to diagnosis and its temporal trend among people with HIV. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of MEDLINE, Embase, and Google Scholar, supplemented by a hand search of bibliographies of articles, was conducted. Study information and outcome measures of time from HIV infection to diagnosis were synthesized. Random-effects metaanalyses were performed. The search identified 12 articles from 4541 unduplicated citations. Studies were conducted in the UK (k = 3), US (k = 3), France (k = 2), Australia (k = 1), Switzerland (k = 1), Netherlands (k = 1), and China (k = 1). The pooled meantime from HIV infection to diagnosis was 3.00 years (95% confidence interval: 2.16-3.84). From 1996 to 2002, meantime reduced from 4.68 to 2.66 years. Subsequently, it increased to 3.20 years in 2003 and remained relatively stable until 2015. In sub-group meta-analyses, men who have sex with men (MSM) had a meantime of 2.62 years (1.91-3.34), while for heterosexuals and people who inject drugs, it was 5.00 (4.15-5.86) and 4.98 (3.97-5.98) years, respectively. In the high- and upper-middle-income countries included in this study, persons live with undiagnosed HIV for about 3 year before being diagnosed. This period is shorter for MSM relative to people with infections attributable to other risk factors.
及时发现 HIV 感染对于最大限度地减少传播事件至关重要。我们旨在评估 HIV 感染者从感染到诊断的时间间隔及其时间趋势。根据系统评价和荟萃分析的首选报告项目指南，我们对 MEDLINE、Embase 和 Google Scholar 进行了搜索，并补充了对文章参考文献的手工搜索。综合了从 HIV 感染到诊断的时间间隔的研究信息和结局指标。进行了随机效应荟萃分析。检索确定了来自 4541 篇未重复引文的 12 篇文章。这些研究分别在英国（k=3）、美国（k=3）、法国（k=2）、澳大利亚（k=1）、瑞士（k=1）、荷兰（k=1）和中国（k=1）进行。从 HIV 感染到诊断的平均时间间隔为 3.00 年（95%置信区间：2.16-3.84）。1996 年至 2002 年，平均时间从 4.68 年缩短至 2.66 年。随后，2003 年增加至 3.20 年，直到 2015 年保持相对稳定。在亚组荟萃分析中，男男性行为者（MSM）的平均时间为 2.62 年（1.91-3.34），而异性恋者和静脉吸毒者的平均时间分别为 5.00 年（4.15-5.86）和 4.98 年（3.97-5.98）。在本研究纳入的高收入和中高收入国家，人们在被诊断出患有未确诊的 HIV 之前，大约有 3 年的时间处于未被诊断的状态。与归因于其他危险因素的感染者相比，MSM 的这段时间较短。
