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Risk factors of "early“ and "late“ diagnosis of HIV infection in Austria
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.
Datei SOEDAK_09_OSD3.pdf