Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018.
<h4>Objectives</h4>With the purpose of reducing the well-known negative impact of late presentation (LP) on people living with HIV (PLWH), guidelines on early HIV diagnosis were published in 2014 in Spain, but since then no data on LP prevalence have been published. To estimate prevalenc...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0249864 |
| _version_ | 1818901629822304256 |
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| author | Marta Rava Lourdes Domínguez-Domínguez Otilia Bisbal Luis Fernando López-Cortés Carmen Busca Antonio Antela Patricia González-Ruano Cristina Hernández Josè-Antonio Iribarren Rafael Rubio Santiago Moreno Inmaculada Jarrín Cohort of the Spanish HIV/AIDS Research Network (CoRIS) |
| author_facet | Marta Rava Lourdes Domínguez-Domínguez Otilia Bisbal Luis Fernando López-Cortés Carmen Busca Antonio Antela Patricia González-Ruano Cristina Hernández Josè-Antonio Iribarren Rafael Rubio Santiago Moreno Inmaculada Jarrín Cohort of the Spanish HIV/AIDS Research Network (CoRIS) |
| author_sort | Marta Rava |
| collection | DOAJ |
| description | <h4>Objectives</h4>With the purpose of reducing the well-known negative impact of late presentation (LP) on people living with HIV (PLWH), guidelines on early HIV diagnosis were published in 2014 in Spain, but since then no data on LP prevalence have been published. To estimate prevalence and risk factors of LP and to evaluate their impact on the development of clinical outcomes in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) during 2004-2018.<h4>Methods</h4>CoRIS is an open prospective multicenter cohort of PLWH, adults, naive to ART at entry. LP was defined as HIV diagnosis with CD4 count ≤350 cells/μL or an AIDS defining event (ADE). Multivariable Poisson regression models were used to estimate both prevalence ratios (PR) for the association of potential risk factors with LP and Incidence rate ratios (IRRs) for its impact on the development of the composite endpoint (first ADE, first serious non-AIDS event [SNAE] or overall mortality).<h4>Results</h4>14,876 individuals were included. Overall, LP prevalence in 2004-2018 was 44.6%. Risk factors for LP included older age, having been infected through injection drug use or heterosexual intercourse, low educational level and originating from non-European countries. LP was associated with an increased risk of the composite endpoint (IRR: 1.34; 95%CI 1.20, 1.50), ADE (1.39; 1.18, 1.64), SNAE (1.22; 1.01, 1.47) and mortality (1.71; 1.41, 2.08).<h4>Conclusions</h4>LP remains a health problem in Spain, mainly among certain populations, and is associated with greater morbidity and mortality. Public policies should be implemented to expand screening and early diagnosis of HIV infection, for a focus on those at greatest risk of LP. |
| first_indexed | 2024-12-19T20:22:48Z |
| format | Article |
| id | doaj.art-5599bd96260a4755b347afd3f25fd513 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-19T20:22:48Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5599bd96260a4755b347afd3f25fd5132022-12-21T20:06:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01164e024986410.1371/journal.pone.0249864Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018.Marta RavaLourdes Domínguez-DomínguezOtilia BisbalLuis Fernando López-CortésCarmen BuscaAntonio AntelaPatricia González-RuanoCristina HernándezJosè-Antonio IribarrenRafael RubioSantiago MorenoInmaculada JarrínCohort of the Spanish HIV/AIDS Research Network (CoRIS)<h4>Objectives</h4>With the purpose of reducing the well-known negative impact of late presentation (LP) on people living with HIV (PLWH), guidelines on early HIV diagnosis were published in 2014 in Spain, but since then no data on LP prevalence have been published. To estimate prevalence and risk factors of LP and to evaluate their impact on the development of clinical outcomes in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) during 2004-2018.<h4>Methods</h4>CoRIS is an open prospective multicenter cohort of PLWH, adults, naive to ART at entry. LP was defined as HIV diagnosis with CD4 count ≤350 cells/μL or an AIDS defining event (ADE). Multivariable Poisson regression models were used to estimate both prevalence ratios (PR) for the association of potential risk factors with LP and Incidence rate ratios (IRRs) for its impact on the development of the composite endpoint (first ADE, first serious non-AIDS event [SNAE] or overall mortality).<h4>Results</h4>14,876 individuals were included. Overall, LP prevalence in 2004-2018 was 44.6%. Risk factors for LP included older age, having been infected through injection drug use or heterosexual intercourse, low educational level and originating from non-European countries. LP was associated with an increased risk of the composite endpoint (IRR: 1.34; 95%CI 1.20, 1.50), ADE (1.39; 1.18, 1.64), SNAE (1.22; 1.01, 1.47) and mortality (1.71; 1.41, 2.08).<h4>Conclusions</h4>LP remains a health problem in Spain, mainly among certain populations, and is associated with greater morbidity and mortality. Public policies should be implemented to expand screening and early diagnosis of HIV infection, for a focus on those at greatest risk of LP.https://doi.org/10.1371/journal.pone.0249864 |
| spellingShingle | Marta Rava Lourdes Domínguez-Domínguez Otilia Bisbal Luis Fernando López-Cortés Carmen Busca Antonio Antela Patricia González-Ruano Cristina Hernández Josè-Antonio Iribarren Rafael Rubio Santiago Moreno Inmaculada Jarrín Cohort of the Spanish HIV/AIDS Research Network (CoRIS) Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. PLoS ONE |
| title | Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. |
| title_full | Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. |
| title_fullStr | Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. |
| title_full_unstemmed | Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. |
| title_short | Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. |
| title_sort | late presentation for hiv remains a major health issue in spain results from a multicenter cohort study 2004 2018 |
| url | https://doi.org/10.1371/journal.pone.0249864 |
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