Late presentation of HIV infection in Oslo University hospital during the period 2000-2010

Abstract

Objectives: In Europe, 15-38% of individuals with HIV infection are diagnosed late in the course of their HIV-infection. Early diagnoses and initiation of antiretroviral therapy can prevent HIV-associated morbidity and mortality as well as reduce onward transmission. The objectives of this study were to investigate the prevalenc of late presenters (LPs), describe trends and indentify risk factors that are associated with late presentation of HIV infection at Oslo University Hospital from 2000-2010.

Methods: All new HIV diagnoses in individuals over the age of 15 years were included. LPs were defined as individuals presenting with a CD4 count < 350 cells/μl or AIDS within three months of their first HIV positive test. We examined factors associated with LPs using descriptive statistics and a multivariate logistic regression model.

Results: 704 of 1000 newly diagnosed HIV-infectied individuals had a CD4 cell count or an AIDS diagnoses within three months of diagnoses. 355 (50,4%) were LPs, and this proportion remained constant over time. Factors associated with late presentation were older age, heterosexual woman, and being born in Sub-Saharan Africa or Asia. Men who have sex with men (MSM) were less likely to present late than other transmission categories, but counted for one third of the total number of LPs.

Conclusions: Late presentation of HIV infection seems to be a similar challenge in Norway as in other European countries. Interventions to encourage earlier HIV-testing in risk groups for late presentation are necessary.