Predictors of late presentation and advanced HIV disease among people living with HIV in Oman (2000–2019)

Elgalib, Ali; Shah, Samir; Wahaibi, Adil Al; Al-Habsi, Zeyana; Al-Fouri, Maha; Lau, Richard; Al-Kindi, Hanan; Al-Rawahi, Bader; Al-Abri, Seif

doi:10.1186/s12889-021-12048-1

Cited by 7 publications

(8 citation statements)

References 27 publications

(35 reference statements)

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“…The results in this study are consistent with previous literatures finding that women are less likely than men to be LP or AHD ( 19 , 47 ). One possible reason was that women have a high likelihood of being tested in their lifetime; for example, they are tested during routine prenatal testing or gynecological follow-up ( 48 ).…”

Section: Discussionsupporting

confidence: 93%

“…With trained peers providing point-of-care testing and case management, nearly 0.2% of MSM lost to receive confirmatory testing ( 46 ). Meanwhile, center of “one-stop service,” might short duration between HIV diagnosis and linkage to care, also improve the healthcare system service ( 47 ). Compared with prior to implementing one-stop service, the coverage rate of CD4 testing rose by 69.2%, and proportion of ART initiation rose by 3 times within 30 days after HIV diagnosed ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trends of late HIV presentation and advance HIV disease among newly diagnosed HIV cases in Jiangsu, China: A serial cross-sectional study from 2008 to 2020

Shi

Tang²,

Liu³

et al. 2022

Front. Public Health

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BackgroundThis study aimed to assess the trends and determine the factors associated with late presentation (LP) and advanced HIV disease (AHD) among newly diagnosed people living with HIV (PLWH) from 2008 to 2020 in Jiangsu, China.MethodsNewly diagnosed PLWH registered in the HIV surveillance system from 2008 to 2020 were included. Multivariable logistic regression models were used to analyze the factors associated with LP and AHD. The LP and AHD trends were assessed using Joint-point analysis.ResultsOf 37,251 newly diagnosed PLWH identified, 30,251(81.2%) patients met the inclusion criteria. Among those, 16,672 (55.1%) were considered LP, and 8,691 (28.7%) had AHD. LP trends steadily increased from 2008 (39.0%) to 2020 (59.4%), but AHD trends decreased visibly from 2016 (32.3%) to 2020 (23.4%). The overall median CD4 trends decreased slowly from 389 to 305 cells/mm3 between 2008 and 2020. Married patients and those older than 35 years were more likely to be LP and have AHD. Patients infected via heterosexual transmission had a higher risk of being classified as AHD (aOR: 1.13, 95%CI: 1.06–1.21) than patients infected via homosexual transmission. Patients that were diagnosed at sexually transmitted infections (STIs) clinics (aOR: 1.10, 95%CI: 1.01–1.20) and in hospitals (aOR: 1.69, 95%CI: 1.59–1.79) were more likely to be classified as LP compared with patients diagnosed at voluntary counseling and testing (VCT) centers. Similar, patients diagnosed at STIs clinics (aOR: 1.23, 95%CI: 1.11–1.36) and hospitals (aOR: 2.27, 95%CI: 2.12–2.43) were more likely to have AHD than patients diagnosed in VCT.ConclusionOur findings indicate an alarming burden of LP in Jiangsu, suggesting the need for more attention toward HIV diagnosis at early CD4 stages. National HIV control programs must strengthen comprehensive interventions for HIV prevention and promote HIV services. Also, strategies for HIV prevention (PrEP and PEP), testing, and treatment must be extended, especially among the general population.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Trends of late HIV presentation and advance HIV disease among newly diagnosed HIV cases in Jiangsu, China: A serial cross-sectional study from 2008 to 2020

Shi

Tang²,

Liu³

et al. 2022

Front. Public Health

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“…Older age was correlated with a higher risk of late diagnosis. Indeed, it was similar to other studies 23,24 . For another reason, the stigma associated with inadequate HIV testing and with HIV testing in healthcare settings, which is particularly common in China, 19 should also be considered an essential factor for late diagnosis among older adults.…”

Section: Discussionsupporting

confidence: 85%

Prevalence and factors associated with late diagnosis among older adults living with HIV in liuzhou, China: 2010−2020

Chu

Zhang

Lan

et al. 2022

Journal of Medical Virology

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This paper aimed to quantify and characterize the prevalence and associated factors for late diagnosis in older adults living with human immunodeficiency virus (HIV) in Liuzhou, China, from 2010 to 2020. The characteristics of older adults living with HIV were described separately in time, space and population. Multivariate logistic regression analysis evaluates the factors influencing late diagnosis in HIV‐positive adults ≥ 50 years of age. The majority of older adults living with HIV were over 60 years old, male, and with CD4 counts < 200 cells/μl at diagnosis, with most late diagnoses being more likely to report heterosexual transmission. These two factors may potentially provide a positive influence on late diagnosis: older and CD4 counts < 500 cells/μl. In contrast, females and those with homosexual or other transmission provide a negative. These results suggest that late diagnosis of HIV‐positive adults ≥ 50 years of age remains a severe and growing epidemiological issue.

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“…To the best of our knowledge, this is one of few studies in the MENA region assessing late presentations of HIV and missed opportunities for earlier diagnosis 17 – 19 , 27 , 28 . We found that more than half of the newly diagnosed subjects in our cohort (51.3%) were late presenters and 35.3% had advanced HIV disease on presentation.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the 2018 UNAIDS report revealed that 26% of individuals newly diagnosed with HIV in Lebanon presented at an advanced stage, characterized by an initial CD4 count below 200 cells/mm 3 31 . Few studies have described late presentations in the MENA region 32 , 33 . Our results are in line with data from Turkey and Iran.…”

Section: Discussionmentioning

confidence: 99%

Late presentations and missed opportunities among newly diagnosed HIV patients presenting to a specialty clinic in Lebanon

Mahmoud,

Ballouz,

Lahoud

et al. 2024

Sci Rep

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Late presentation to medical care of individuals infected with the human immunodeficiency virus (HIV) is linked to poor outcomes and increased morbidity and mortality. Missed opportunities for a prompt diagnosis are frequently reported among late presenters. We aimed to estimate the proportion of late presenters and missed opportunities in diagnosis among newly diagnosed HIV-positive subjects presenting to a specialty clinic in Lebanon. This is a retrospective chart review of all newly diagnosed adult HIV-positive subjects presenting to clinic from 2012 to 2022. Demographic, laboratory, and clinical data were collected at initial HIV diagnosis or presentation to medical care. We defined late presentation as having a CD4 count < 350 or AIDS-defining event regardless of CD4 count. Advanced disease is defined as having a CD4 count below 200 cells/μL or the presence of an AIDS-defining illness, regardless of the CD4 count. A missed opportunity was defined as the presence of an indicator condition (IC) that suggests infection with HIV/AIDS during 3 years preceding the actual HIV diagnosis and not followed by a recommendation for HIV testing. The proportions for demographic, epidemiological, and clinical characteristics are calculated by excluding cases with missing information from the denominator. Our cohort included 150 subjects (92.7% males; 63.6% men who have sex with men (MSM); 33.3% heterosexuals; median age 30.5 years at diagnosis). 77 (51.3%) were late presenters and 53 (35.3% of all subjects, 68.8% of late presenters) had advanced HIV on presentation. Up to 76.5% of late presenters had a presentation with an HIV-related condition at a healthcare provider without getting HIV test within the previous 3 years. The most frequent ICs were weight loss, generalized lymphadenopathy, constitutional symptoms, and chronic idiopathic diarrhea. Overall mortality rate was 4% (6/150 individuals). All-cause mortality among those who presented with AIDS was 15.4% (6/39 subjects). In our setting, late presentations and missed opportunities for HIV diagnosis are common. In the Middle East, AIDS mortality remains high with a large gap in HIV testing. To effectively influence policies, comprehensive analyses should focus on estimating the preventable health and financial burdens of late HIV presentations. Another concern pertains to healthcare providers’ attitudes and competencies.

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Predictors of late presentation and advanced HIV disease among people living with HIV in Oman (2000–2019)

Cited by 7 publications

References 27 publications

Trends of late HIV presentation and advance HIV disease among newly diagnosed HIV cases in Jiangsu, China: A serial cross-sectional study from 2008 to 2020

Trends of late HIV presentation and advance HIV disease among newly diagnosed HIV cases in Jiangsu, China: A serial cross-sectional study from 2008 to 2020

Prevalence and factors associated with late diagnosis among older adults living with HIV in liuzhou, China: 2010−2020

Late presentations and missed opportunities among newly diagnosed HIV patients presenting to a specialty clinic in Lebanon

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