Institute of Tropical Medicine Antwerp
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Late presentation to HIV testing is overestimated when based on the consensus definition

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Show simple item record Sasse, A. Florence, E. Pharris, A. De Wit, S. Lacor, P. Van Beckhoven, D. Deblonde, J. Delforge, M. L. Fransen, K. Goffard, J. C. Legrand, J. C. Moutschen, M. Pierard, D. Ruelle, J. Vaira, D. Vandercam, B. Van Ranst, M. Van Wijngaerden, E. Vandekerckhove, L. Verhofstede, C. 2016-05-04T07:48:23Z 2016-05-04T07:48:23Z 2016
dc.identifier.issn 1464-2662
dc.identifier.other ITG-C2A
dc.identifier.other ITG-C9A
dc.identifier.other DCS
dc.identifier.other U-STDCLI
dc.identifier.other U-ARLAB
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other Abstract
dc.identifier.other UPD61
dc.description.abstract OBJECTIVES: In 2011, a consensus was reached defining "late presenters" (LPs) as individuals presenting for care with a CD4 count < 350 cells/muL or with an AIDS-defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account. METHODS: Case surveillance data for newly diagnosed patients in Belgium in 1998-2012 were analysed, including CD4 count at diagnosis, the presence of AIDS-defining events, and recent infections (< 6 months) as reported by clinicians in the case of acute illness or a recent negative test. First, proportions of LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as "nonlate" if infections were reported as recent. RESULTS: A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P < 0.001). The proportion of patients misclassified as LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012. CONCLUSIONS: This study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. en_US
dc.language English en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Homosexuals en_US
dc.subject Health care seeking behavior en_US
dc.subject CD4 lymphocyte count en_US
dc.subject Testing en_US
dc.subject Diagnosis delay en_US
dc.subject Clinical en_US
dc.subject Staging en_US
dc.subject Estimation en_US
dc.subject Consensus en_US
dc.subject Case definition en_US
dc.subject Belgium en_US
dc.subject Europe, West en_US
dc.title Late presentation to HIV testing is overestimated when based on the consensus definition en_US
dc.type Article en_US
dc.citation.issue 3 en_US
dc.citation.jtitle HIV Medicine en_US
dc.citation.volume 17 en_US
dc.citation.pages 231-234 en_US
dc.citation.jabbreviation HIV Med en_US

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