Mario Sarcletti¹, Stefanie Gogl², Margret Jöchl³, Armin Rieger⁴, Maria Geit⁵, Bernhard Haas⁶, Ninon Taylor⁷, Manfred Kanatschnig⁸, Robert Zangerle

Background: Frequency and risk factors of patients in Austria with "early“ and “late” stage of disease at diagnosis of HIV infection.
Methods: Participants of the Austrian HIV Cohort Study with a diagnosis of HIV infection from 2001 to 2008. “Early diagnosis“ was defined by primary infection (western blot pattern or Antigen/HIV RNA combined with the clinical picture) or documented seroconversion within 3 years. “Late diagnosis“ was defined by a CD4 cell count < 200 cells/l and/or AIDS within 6 and 3 months, respectively, of diagnosis of HIV infection. Risk calculation was done by logistic and Cox regression.
Results: Overall 1666 persons had been diagnosed with HIV infection, 1196 were men (71,8%), 470 women (28,2%), 546 patients (32,8%) were men who had sex with man (MSM), 232 (13,9%) injecting drug users (IDU) and 733 (44,0%) heterosexual contacts,. An “early” diagnosis has been made in 291 patients (17,5%), more frequently in MSM (RR=1,82, p< 0,001) and in patients with residency outside Vienna (RR=1,64, p< 0,001) and much less frequently in patients originating from high prevalence areas (RR=0,28, p< 0,001). A “late” diagnosis has been made in 432 patients (25,9%). A higher risk for “late” presentation was found in patients with residency outside Vienna (RR=1,35, p=0,019). A lower frequency of “late” presentation was observed in younger patients (< 37 years; RR=0,47, p< 0,001), MSM (RR=0,41, p< 0,001) and in IDU (RR=0,36, p< 0,001). The frequency of "late diagnosis“ did not change essentially from 2001 to 2008 and was associated with a higher risk of mortality (HR=3,36, p< 0,001).
Conclusions: Late diagnosis of HIV infection is frequent in Austria and an independent risk factor for mortality. Risk factors for early and late presentation have been identified and may provide a basis for a more efficacious testing for HIV infection.