Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis
ObjectiveDelayed diagnosis of HIV can lead to an inappropriate response to antiretroviral therapy (ART), rapid progression of the disease, and death. It can also carry harmful effects on public health due to the increment of transmission. This study aimed to estimate the duration of delayed diagnosi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1029608/full |
| _version_ | 1827965889207599104 |
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| author | Mehdi Sharafi Alireza Mirahmadizadeh Jafar Hassanzadeh Mozhgan Seif Alireza Heiran |
| author_facet | Mehdi Sharafi Alireza Mirahmadizadeh Jafar Hassanzadeh Mozhgan Seif Alireza Heiran |
| author_sort | Mehdi Sharafi |
| collection | DOAJ |
| description | ObjectiveDelayed diagnosis of HIV can lead to an inappropriate response to antiretroviral therapy (ART), rapid progression of the disease, and death. It can also carry harmful effects on public health due to the increment of transmission. This study aimed to estimate the duration of delayed diagnosis (DDD) in HIV patients in Iran.MethodsThis hybrid cross-sectional cohort study was conducted on the national HIV surveillance system database (HSSD). Linear mixed effect models with random intercept, random slope, and both were used to estimate the parameters required for the CD4 depletion model to determine the best-fitted model for DDD, stratified by the route of transmission, gender, and age group.ResultsThe DDD was estimated in 11,373 patients including 4,762 (41.87%) injection drug users (IDUs), 512 (4.5%) men who had sexual contact with men (MSM), 3,762 (33.08%) patients with heterosexual contacts, and 2,337 (20.55%) patients who were infected through other routes of HIV transmission. The total mean DDD was 8.41 ± 5.97 years. The mean DDD was 7.24 ± 0.08 and 9.43 ± 6.83 years in male and female IDUs, respectively. In the heterosexual contact group, DDD was obtained as 8.60 ± 6.43 years in male patients and 9.49 ± 7.17 years in female patients. It was also estimated as 9.37 ± 7.30 years in the MSM group. Furthermore, patients infected through other transmission routes were found with a DDD of 7.90 ± 6.74 years for male patients and a DDD of 7.87 ± 5.87 years for female patients.ConclusionA simple CD4 depletion model analysis is represented, which incorporates a pre-estimation step to determine the best-fitted linear mixed model for calculating the parameters required for the CD4 depletion model. Considering such a noticeably high HIV diagnostic delay, especially in older adults, MSM, and heterosexual contact groups, regular periodic screening is required to reduce the DDD. |
| first_indexed | 2024-04-09T17:41:28Z |
| format | Article |
| id | doaj.art-305b2c92387e4107b2f6802d97c7adf7 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-09T17:41:28Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-305b2c92387e4107b2f6802d97c7adf72023-04-17T05:13:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-04-011110.3389/fpubh.2023.10296081029608Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysisMehdi Sharafi0Alireza Mirahmadizadeh1Jafar Hassanzadeh2Mozhgan Seif3Alireza Heiran4Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IranNon-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Epidemiology, School of Health, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, IranNon-communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, IranNon-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, IranObjectiveDelayed diagnosis of HIV can lead to an inappropriate response to antiretroviral therapy (ART), rapid progression of the disease, and death. It can also carry harmful effects on public health due to the increment of transmission. This study aimed to estimate the duration of delayed diagnosis (DDD) in HIV patients in Iran.MethodsThis hybrid cross-sectional cohort study was conducted on the national HIV surveillance system database (HSSD). Linear mixed effect models with random intercept, random slope, and both were used to estimate the parameters required for the CD4 depletion model to determine the best-fitted model for DDD, stratified by the route of transmission, gender, and age group.ResultsThe DDD was estimated in 11,373 patients including 4,762 (41.87%) injection drug users (IDUs), 512 (4.5%) men who had sexual contact with men (MSM), 3,762 (33.08%) patients with heterosexual contacts, and 2,337 (20.55%) patients who were infected through other routes of HIV transmission. The total mean DDD was 8.41 ± 5.97 years. The mean DDD was 7.24 ± 0.08 and 9.43 ± 6.83 years in male and female IDUs, respectively. In the heterosexual contact group, DDD was obtained as 8.60 ± 6.43 years in male patients and 9.49 ± 7.17 years in female patients. It was also estimated as 9.37 ± 7.30 years in the MSM group. Furthermore, patients infected through other transmission routes were found with a DDD of 7.90 ± 6.74 years for male patients and a DDD of 7.87 ± 5.87 years for female patients.ConclusionA simple CD4 depletion model analysis is represented, which incorporates a pre-estimation step to determine the best-fitted linear mixed model for calculating the parameters required for the CD4 depletion model. Considering such a noticeably high HIV diagnostic delay, especially in older adults, MSM, and heterosexual contact groups, regular periodic screening is required to reduce the DDD.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1029608/fulldelayed diagnosisHIVCD4 depletion modelIranAIDS |
| spellingShingle | Mehdi Sharafi Alireza Mirahmadizadeh Jafar Hassanzadeh Mozhgan Seif Alireza Heiran Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis Frontiers in Public Health delayed diagnosis HIV CD4 depletion model Iran AIDS |
| title | Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis |
| title_full | Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis |
| title_fullStr | Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis |
| title_full_unstemmed | Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis |
| title_short | Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis |
| title_sort | duration of delayed diagnosis in hiv aids patients in iran a cd4 depletion model analysis |
| topic | delayed diagnosis HIV CD4 depletion model Iran AIDS |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1029608/full |
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