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Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

BACKGROUND: Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality. METHODS AND FINDINGS: LP was defined in Collaboration of Observational HIV Epidemiological Re...

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Autores principales: Mocroft, Amanda, Lundgren, Jens D., Sabin, Miriam Lewis, Monforte, Antonella d'Arminio, Brockmeyer, Norbert, Casabona, Jordi, Castagna, Antonella, Costagliola, Dominique, Dabis, Francois, De Wit, Stéphane, Fätkenheuer, Gerd, Furrer, Hansjakob, Johnson, Anne M., Lazanas, Marios K., Leport, Catherine, Moreno, Santiago, Obel, Niels, Post, Frank A., Reekie, Joanne, Reiss, Peter, Sabin, Caroline, Skaletz-Rorowski, Adriane, Suarez-Lozano, Ignacio, Torti, Carlo, Warszawski, Josiane, Zangerle, Robert, Fabre-Colin, Céline, Kjaer, Jesper, Chene, Genevieve, Grarup, Jesper, Kirk, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796947/
https://www.ncbi.nlm.nih.gov/pubmed/24137103
http://dx.doi.org/10.1371/journal.pmed.1001510
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author Mocroft, Amanda
Lundgren, Jens D.
Sabin, Miriam Lewis
Monforte, Antonella d'Arminio
Brockmeyer, Norbert
Casabona, Jordi
Castagna, Antonella
Costagliola, Dominique
Dabis, Francois
De Wit, Stéphane
Fätkenheuer, Gerd
Furrer, Hansjakob
Johnson, Anne M.
Lazanas, Marios K.
Leport, Catherine
Moreno, Santiago
Obel, Niels
Post, Frank A.
Reekie, Joanne
Reiss, Peter
Sabin, Caroline
Skaletz-Rorowski, Adriane
Suarez-Lozano, Ignacio
Torti, Carlo
Warszawski, Josiane
Zangerle, Robert
Fabre-Colin, Céline
Kjaer, Jesper
Chene, Genevieve
Grarup, Jesper
Kirk, Ole
author_facet Mocroft, Amanda
Lundgren, Jens D.
Sabin, Miriam Lewis
Monforte, Antonella d'Arminio
Brockmeyer, Norbert
Casabona, Jordi
Castagna, Antonella
Costagliola, Dominique
Dabis, Francois
De Wit, Stéphane
Fätkenheuer, Gerd
Furrer, Hansjakob
Johnson, Anne M.
Lazanas, Marios K.
Leport, Catherine
Moreno, Santiago
Obel, Niels
Post, Frank A.
Reekie, Joanne
Reiss, Peter
Sabin, Caroline
Skaletz-Rorowski, Adriane
Suarez-Lozano, Ignacio
Torti, Carlo
Warszawski, Josiane
Zangerle, Robert
Fabre-Colin, Céline
Kjaer, Jesper
Chene, Genevieve
Grarup, Jesper
Kirk, Ole
author_sort Mocroft, Amanda
collection PubMed
description BACKGROUND: Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality. METHODS AND FINDINGS: LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm(3) or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95–0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19–20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55–12.43). CONCLUSIONS: LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP. Please see later in the article for the Editors' Summary
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spelling pubmed-37969472013-10-17 Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE) Mocroft, Amanda Lundgren, Jens D. Sabin, Miriam Lewis Monforte, Antonella d'Arminio Brockmeyer, Norbert Casabona, Jordi Castagna, Antonella Costagliola, Dominique Dabis, Francois De Wit, Stéphane Fätkenheuer, Gerd Furrer, Hansjakob Johnson, Anne M. Lazanas, Marios K. Leport, Catherine Moreno, Santiago Obel, Niels Post, Frank A. Reekie, Joanne Reiss, Peter Sabin, Caroline Skaletz-Rorowski, Adriane Suarez-Lozano, Ignacio Torti, Carlo Warszawski, Josiane Zangerle, Robert Fabre-Colin, Céline Kjaer, Jesper Chene, Genevieve Grarup, Jesper Kirk, Ole PLoS Med Research Article BACKGROUND: Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality. METHODS AND FINDINGS: LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm(3) or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95–0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19–20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55–12.43). CONCLUSIONS: LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP. Please see later in the article for the Editors' Summary Public Library of Science 2013-09-03 /pmc/articles/PMC3796947/ /pubmed/24137103 http://dx.doi.org/10.1371/journal.pmed.1001510 Text en © 2013 Mocroft et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Mocroft, Amanda
Lundgren, Jens D.
Sabin, Miriam Lewis
Monforte, Antonella d'Arminio
Brockmeyer, Norbert
Casabona, Jordi
Castagna, Antonella
Costagliola, Dominique
Dabis, Francois
De Wit, Stéphane
Fätkenheuer, Gerd
Furrer, Hansjakob
Johnson, Anne M.
Lazanas, Marios K.
Leport, Catherine
Moreno, Santiago
Obel, Niels
Post, Frank A.
Reekie, Joanne
Reiss, Peter
Sabin, Caroline
Skaletz-Rorowski, Adriane
Suarez-Lozano, Ignacio
Torti, Carlo
Warszawski, Josiane
Zangerle, Robert
Fabre-Colin, Céline
Kjaer, Jesper
Chene, Genevieve
Grarup, Jesper
Kirk, Ole
Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title_full Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title_fullStr Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title_full_unstemmed Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title_short Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)
title_sort risk factors and outcomes for late presentation for hiv-positive persons in europe: results from the collaboration of observational hiv epidemiological research europe study (cohere)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796947/
https://www.ncbi.nlm.nih.gov/pubmed/24137103
http://dx.doi.org/10.1371/journal.pmed.1001510
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