Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
J Med Virol. 2023 May;95(5):e28781. doi: 10.1002/jmv.28781.
To identify the frequency of late presentation and late presentation with advanced disease, and associated factors in people living with HIV (PLHIV). Data from PLHIV diagnosed between 2008 and 2021 were retrospectively analyzed. Time of diagnosis (categorized based on key events affecting HIV care continuum e.g., national strategies, HIV guidelines, COVID-19 pandemic) and characteristics of late presenters (LP: CD4 ≤350 cells/mm³ or an AIDS defining event) and late presenters with advanced disease (LPAD: CD4 <200 cells/mm³) were describe. Associations between dependent (LP, LPAD) and independent variables were assessed using univariate/multivariate regression tests and presented as odds ratios (95% confidential interval). Of 1585 individuals (93.7% men), 42.5% were LPs and 19.3% were LPADs. Most common route of transmission was sex between men (54.3%). Non-LPs were younger (30 vs. 34 and 36 years; p < 0.001) and included more men who have sex with men (60.3% vs. 46.3% and 39.5%; p < 0.001). Factors associated with being LP and LPAD were age >30 years, heterosexual/unknown route of transmission (vs. sex between men), diagnosis in 2008-2013 or 2020-2021, (vs. 2014-2019). With reference to Turkish subjects, migrants from Africa had higher odds of being LPAD. LP is still an important health issue in HIV care. Heterosexuality, older age (>30 years), migration from Africa, and the COVID-19 pandemic are associated with delays in HIV presentation in Turkey. These factors need to be considered when developing and implementing policies to enable earlier diagnosis and treatment of PLHIV to achieve UNAIDS 95-95-95 targets.
为了确定艾滋病毒感染者（PLHIV）中晚期出现和晚期出现合并疾病的频率以及相关因素。回顾性分析了 2008 年至 2021 年间诊断出的 PLHIV 数据。根据影响 HIV 护理连续体的关键事件（例如国家战略、HIV 指南、COVID-19 大流行）对诊断时间（进行分类）和晚期患者（LP：CD4≤350 个细胞/mm³或艾滋病定义性事件）和晚期出现合并疾病的晚期患者（LPAD：CD4<200 个细胞/mm³）的特征进行描述。使用单变量/多变量回归检验评估依赖（LP、LPAD）和独立变量之间的关联，并以比值比（95%置信区间）表示。在 1585 名个体（93.7%为男性）中，42.5%为 LP，19.3%为 LPAD。最常见的传播途径是男男性行为（54.3%）。非 LP 患者更年轻（30 岁与 34 岁和 36 岁；p<0.001），且包括更多的男男性行为者（60.3%与 46.3%和 39.5%；p<0.001）。与 LP 和 LPAD 相关的因素包括年龄>30 岁、异性恋/未知传播途径（与男男性行为相比）、2008-2013 年或 2020-2021 年诊断（与 2014-2019 年相比）。与土耳其人相比，来自非洲的移民 LPAD 的可能性更高。LP 仍然是 HIV 护理中的一个重要健康问题。异性恋、年龄较大（>30 岁）、来自非洲的移民以及 COVID-19 大流行与土耳其的 HIV 呈现延迟相关。在制定和实施政策以实现 UNAIDS 95-95-95 目标，实现 PLHIV 的早期诊断和治疗时，需要考虑这些因素。
