Decrease in late presentation for HIV care in Kinshasa, DRC, 2006–2020

Abstract

Introduction Late presentation for HIV care is a well-described issue for the success of ART outcomes and the cause of higher morbidity, mortality and further transmission. Monitoring the level of late presentation and understanding the factors associated with it would help to tailor screening and information strategies for better efficiency. We performed a retrospective cohort study in Kinshasa, the capital of the DRC. The studied population included HIV-positive adults newly enrolled in HIV care between January 2006 and June 2020 at 25 HIV urban care facilities. Patient information collected at presentation for HIV care included age, sex, WHO clinical stage and screening context. We used 2 definitions of late presentation: the WHO definition of advanced HIV disease (WHO stage 3/4 or CD4 cell count < 200 cells/mm3) and a more inclusive definition (WHO stage 3/4 or CD4 cell count < 350 cells/mm3). Results A total of 10,137 HIV-infected individuals were included in the analysis. The median age was 40 years; 68% were female. A total of 45.9% or 47.5% of the patients were late presenters, depending on the definition used. The percentage of patients with late presentation (defined as WHO stage 3/4 or CD4 cell count < 350 cells/mm3) decreased during recent years, from 70.7% in 2013 to 46.5% in 2017 and 23.4% in 2020. Age was associated with a significantly higher risk of LP (p < 0.0001). We did not observe any impact of sex. Conclusions The frequency of late presentation for care is decreasing in Kinshasa, DRC. Efforts have to be continued. In particular, the issue of late diagnosis in older individuals should be addressed.

Real-world data in late presentation of HIV infection in Suzhou, China: Results from four consecutive cross-sectional surveys, 2017–2020

“…Consistent with most studies ( 12 , 14 , 15 , 20 , 21 , 27 ), age was significantly associated with late presentation of HIV infection in this study. Late presenters were more elderly.…”

“…It is different from most studies. In recent years, there had been decreasing trends among late presenters in Turkey ( 14 ), Kinshasa of DRC ( 15 ), and the East of England ( 16 ). In addition, trends in late presentation of HIV infection remained relatively stable in Australia ( 17 ), Panama ( 18 ), and Guangxi of China ( 12 ).…”

Infecciones oportunistas de acuerdo con el conteo de linfocitos T CD4+ en pacientes con VIH en un centro de referencia terciaria

“…La infección por VIH representa un problema de salud pública debido al gran impacto económico que representa (14). En la población descrita, las IO fueron más frecuentes en hombres (65.3 vs 34.7%) y una edad general que varía entre 33 y 44 años, datos similares a poblaciones descritas en otras ciudades de nuestro país y otros países de América Latina y Europa (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Se encontró que la prevalencia general de desnutrición es alta (37.9%), comparable con la tasa de desnutrición en pacientes hospitalizados con SIDA en grupos similares (18,19), probablemente se debe a que la mayoría de los pacientes admitidos tenían un compromiso inmunológico severo con LTCD4+ <200 cels/mm 3 , lo que se sabe que está relacionado con la desnutrición (20).…”

“…La definición europea actual de diagnóstico tardío (DT) en un individuo es un recuento de LTCD4+ de menos de 350 cels/mm 3 y/o una enfermedad que define el SIDA en el momento del diagnóstico (10,11). Nosotros optamos por la definición de DT de la OMS: recuento de LTCD4+ por debajo de 200 cels/mm 3 o un estadio clínico OMS 3 o 4 al momento del diagnóstico (12).…”

Impact de la COVID-19 sur les services de prévention du VIH et de prise en charge des personnes vivant avec le VIH dans la ville de Bukavu : une étude mixte séquentielle explicative

“…Comme dans les autres villes congolaises (Ngongo et al, 2021), la prévention, le dépistage et les soins du VIH sont organisés à Bukavu en faveur des enfants, des adultes et des jeunes (Riziki et al, 2021). À Bukavu, plus de 25 000 personnes sont prises en charge pour le VIH dont plus de 3 900 au CTA de l'Hôpital général de référence de Panzi (Duhant et al, 2023).…”