Late diagnosis of HIV remains a serious problem across Europe, results of a large study published in PLos Medicine show.
The research involved approximately 85,000 people diagnosed with HIV between 2000 and 2011 in 35 European countries.
Overall, 54% of patients were diagnosed late and a third presented very late. There was a fall in the proportion of people being diagnosed late, but in 2010/11 over half of patients were still presenting for care with a CD4 cell low enough to warrant immediate antiretroviral therapy.
“Late presentation remains a significant issue across Europe and in all HIV exposure groups,” comment the authors. “Late presentation was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis.” The investigators believe their findings have important implications for HIV testing strategies.
Previous research has analysed late diagnosis rates in individual countries, but little is known about trends across Europe and data from Eastern Europe are especially scarce.
Investigators from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study therefore examined trends and risk factors for late diagnosis between 2000 and 2011. Their study included 84,524 people who presented for HIV care in 35 countries.
Patients were considered to have been diagnosed late if they had a CD4 cell count below 350 cells/mm3 at the time of presentation or developed an AIDS-defining illness within six months of entering care. Very late diagnosis was defined as presentation with a CD4 cell count below 200 cells/mm3.
Overall, 54% of patients were diagnosed late. Rates of late presentation were especially high among heterosexual men (66%), individuals originating from Africa (65%) and patients receiving care in southern Europe (57%).
