Risk Factors in Individuals Living with HIV Presenting Late Diagnosis and the Epidemiology of the Opportunistic Infections, Our 10 Years Long Experience

Abstract

Introduction: Early diagnosis in individuals living with HIV is very important for UNAIDS 90-90-90 targets. However, late diagnosis makes it difficult or each targets such as HIV treatment strategies, secondary transmission and cost-effectiveness. For this purpose, we aimed to evaluate the risk factors, opportunistic infection rates and CD4 T lymphocyte distributions by years in our patients followed up with a late diagnosis. Materials and Methods: The records of HIV-infected patients admitted with a new diagnosis between 2010-2021 were retrospectively analyzed. Demographics features, CD4T lymphocyte counts, HIV RNA levels of the patients were obtained from hospital records, patient files, and reference laboratory records. Late diagnosis was defined as a CD4T lymphocyte cell count of 350 or lessor an AIDS-defining disease independent from CD4 T lymphocyte count. Results: 240 of the 257 HIV-infected patients that we follow were involved in the study due to appling to our clinic with a new diagnosis and the initial values were reached to CD4T lymphocyte. The average age was 42 (18-78) and %88 male (213/240). 48.3% (116/240) of these patients were followed up with a late diagnosis. Comparing patients with CD4T lymphocyte below 350 and above; there was a statistically significant difference between age (p= 0.042), marital status (p= 0.002), transmission route (p= 0.003) and transmission year (p= 0.027). Nineteen (8%) patients were followed up with opportunistic infections and CD4 T lymphocyte was found below 200 in all of these patients. Conclusion: Late diagnosis is a major barrier to the achievement of UNAIDS 90-90-90 goals and cause of morbidity and mortality. It was determined that married and heterosexual groups applied with late diagnosis more than homosexual groups. These findings suggest that these groups do not have enough awareness about HIV infection. We believe that determining the risk factors in patients presenting with a late diagnosis will be an important guide to identify patients with early diagnosis.

Keywords

• late presentation
• human immunodeficiency virus infection
• acquired immunodeficiency syndrome