Associations of HIV testing and late diagnosis at a Japanese university hospital
OBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital bet...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2016-02-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322016000200073&lng=en&tlng=en |
| _version_ | 1818232798719246336 |
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| author | Tetsuya Horino Fumiya Sato Tetsuro Kato Yumiko Hosaka Akihiro Shimizu Shinji Kawano Tokio Hoshina Kazuhiko Nakaharai Yasushi Nakazawa Koji Yoshikawa Masaki Yoshida Seiji Hori |
| author_facet | Tetsuya Horino Fumiya Sato Tetsuro Kato Yumiko Hosaka Akihiro Shimizu Shinji Kawano Tokio Hoshina Kazuhiko Nakaharai Yasushi Nakazawa Koji Yoshikawa Masaki Yoshida Seiji Hori |
| author_sort | Tetsuya Horino |
| collection | DOAJ |
| description | OBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed. RESULTS: A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell count <350/mm3) and very late (CD4 cell count <200/mm3) diagnoses were observed in 61.4% (282/459) and 36.6% (168/459) of patients, respectively. The most common reason for HIV diagnosis was voluntary testing (38.6%, 177/459 patients), followed by AIDS-defining illness (18.3%, 84/459 patients). Multivariate analysis revealed a significant association of voluntary HIV testing with non-late and non-very-late diagnoses and there was a high proportion of AIDS-defining illness in the late and very late diagnosis groups compared with other groups. Men who have sex with men was a relative factor for non-late diagnosis, whereas nonspecific abnormal blood test results, such as hypergammaglobulinemia and thrombocytopenia, were risk factors for very late diagnosis. CONCLUSIONS: Voluntary HIV testing should be encouraged and physicians should screen all patients who have symptoms or signs and particularly hypergammaglobulinemia and thrombocytopenia, that may nonspecifically indicate HIV infection. |
| first_indexed | 2024-12-12T11:12:01Z |
| format | Article |
| id | doaj.art-a4844ff64275480b8688189e221b6d89 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T11:12:01Z |
| publishDate | 2016-02-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-a4844ff64275480b8688189e221b6d892022-12-22T00:26:17ZengElsevier EspañaClinics1980-53222016-02-01712737710.6061/clinics/2016(02)04S1807-59322016000200073Associations of HIV testing and late diagnosis at a Japanese university hospitalTetsuya HorinoFumiya SatoTetsuro KatoYumiko HosakaAkihiro ShimizuShinji KawanoTokio HoshinaKazuhiko NakaharaiYasushi NakazawaKoji YoshikawaMasaki YoshidaSeiji HoriOBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed. RESULTS: A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell count <350/mm3) and very late (CD4 cell count <200/mm3) diagnoses were observed in 61.4% (282/459) and 36.6% (168/459) of patients, respectively. The most common reason for HIV diagnosis was voluntary testing (38.6%, 177/459 patients), followed by AIDS-defining illness (18.3%, 84/459 patients). Multivariate analysis revealed a significant association of voluntary HIV testing with non-late and non-very-late diagnoses and there was a high proportion of AIDS-defining illness in the late and very late diagnosis groups compared with other groups. Men who have sex with men was a relative factor for non-late diagnosis, whereas nonspecific abnormal blood test results, such as hypergammaglobulinemia and thrombocytopenia, were risk factors for very late diagnosis. CONCLUSIONS: Voluntary HIV testing should be encouraged and physicians should screen all patients who have symptoms or signs and particularly hypergammaglobulinemia and thrombocytopenia, that may nonspecifically indicate HIV infection.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322016000200073&lng=en&tlng=enHIV TestingLate DiagnosisVoluntary HIV TestingHypergammaglobulinemiaThrombocytopenia |
| spellingShingle | Tetsuya Horino Fumiya Sato Tetsuro Kato Yumiko Hosaka Akihiro Shimizu Shinji Kawano Tokio Hoshina Kazuhiko Nakaharai Yasushi Nakazawa Koji Yoshikawa Masaki Yoshida Seiji Hori Associations of HIV testing and late diagnosis at a Japanese university hospital Clinics HIV Testing Late Diagnosis Voluntary HIV Testing Hypergammaglobulinemia Thrombocytopenia |
| title | Associations of HIV testing and late diagnosis at a Japanese university hospital |
| title_full | Associations of HIV testing and late diagnosis at a Japanese university hospital |
| title_fullStr | Associations of HIV testing and late diagnosis at a Japanese university hospital |
| title_full_unstemmed | Associations of HIV testing and late diagnosis at a Japanese university hospital |
| title_short | Associations of HIV testing and late diagnosis at a Japanese university hospital |
| title_sort | associations of hiv testing and late diagnosis at a japanese university hospital |
| topic | HIV Testing Late Diagnosis Voluntary HIV Testing Hypergammaglobulinemia Thrombocytopenia |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322016000200073&lng=en&tlng=en |
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