Prevalence of HIV indicator conditions in late presenting patients with HIV: a missed opportunity for diagnosis?

Y. D. Lin, S. E. Garner, J. S.Y. Lau, T. M. Korman, I. J. Woolley

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: To evaluate prior prevalence of HIV indicator conditions in late-presenters with HIV infection. Design: Retrospective cohort study between 2000 and 2014 in a healthcare network in Melbourne, Australia comparing patients presenting with late diagnosis of HIV infection (CD4 < 350 cells/ml) to those patients who had a CD greater than or equal to 350 cells/ml at presentation. Method: The European AIDS Clinical Society guidelines on HIV indicator guided testing were used to assess for any indicator conditions in their prior medical history which may have represented a missed opportunity for earlier diagnosis. Main outcome measures: Descriptive statistics and prevalence of HIV indicator conditions. Results: Of 436 patients with HIV infection, 82 were late presenters. Late presenters were more commonly male (83% vs. 75%, P = 0.11), older (mean age 45 vs. 39 years), born overseas (61% vs. 58%, P = 0.68) and report heterosexual transmission as their exposure risk (51% vs. 31%, P < 0.001). Of 80 patients with late presentation of HIV infection, 54 (55%) had at least one, 29 (36%) at least 2, 12 (15%) at least 3 and 5 (6%) had 4 or more previous HIV indicator conditions which would have triggered HIV testing according to guidelines. The most common indicator conditions were: unexplained loss of weight (31%), herpes zoster (10%), thrombocytopenia or leukopenia (10%), oral or oesophageal candidiasis (10%) and community acquired pneumonia (9%). Twenty patients (25%) had HIV indicator conditions diagnosed at least 12 months before the eventual diagnosis of HIV infection. Discussion/ Conclusion: Patients diagnosed with late-presenting HIV often had an HIV indicator condition prior to presentation, presenting a missed opportunity for earlier diagnosis.

Original languageEnglish
Pages (from-to)17-21
Number of pages5
JournalQJM
Volume112
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Cite this

@article{25088189cba248f19de9dbe1f30bf1e6,
title = "Prevalence of HIV indicator conditions in late presenting patients with HIV: a missed opportunity for diagnosis?",
abstract = "Aim: To evaluate prior prevalence of HIV indicator conditions in late-presenters with HIV infection. Design: Retrospective cohort study between 2000 and 2014 in a healthcare network in Melbourne, Australia comparing patients presenting with late diagnosis of HIV infection (CD4 < 350 cells/ml) to those patients who had a CD greater than or equal to 350 cells/ml at presentation. Method: The European AIDS Clinical Society guidelines on HIV indicator guided testing were used to assess for any indicator conditions in their prior medical history which may have represented a missed opportunity for earlier diagnosis. Main outcome measures: Descriptive statistics and prevalence of HIV indicator conditions. Results: Of 436 patients with HIV infection, 82 were late presenters. Late presenters were more commonly male (83{\%} vs. 75{\%}, P = 0.11), older (mean age 45 vs. 39 years), born overseas (61{\%} vs. 58{\%}, P = 0.68) and report heterosexual transmission as their exposure risk (51{\%} vs. 31{\%}, P < 0.001). Of 80 patients with late presentation of HIV infection, 54 (55{\%}) had at least one, 29 (36{\%}) at least 2, 12 (15{\%}) at least 3 and 5 (6{\%}) had 4 or more previous HIV indicator conditions which would have triggered HIV testing according to guidelines. The most common indicator conditions were: unexplained loss of weight (31{\%}), herpes zoster (10{\%}), thrombocytopenia or leukopenia (10{\%}), oral or oesophageal candidiasis (10{\%}) and community acquired pneumonia (9{\%}). Twenty patients (25{\%}) had HIV indicator conditions diagnosed at least 12 months before the eventual diagnosis of HIV infection. Discussion/ Conclusion: Patients diagnosed with late-presenting HIV often had an HIV indicator condition prior to presentation, presenting a missed opportunity for earlier diagnosis.",
author = "Lin, {Y. D.} and Garner, {S. E.} and Lau, {J. S.Y.} and Korman, {T. M.} and Woolley, {I. J.}",
year = "2019",
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language = "English",
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Prevalence of HIV indicator conditions in late presenting patients with HIV : a missed opportunity for diagnosis? / Lin, Y. D.; Garner, S. E.; Lau, J. S.Y.; Korman, T. M.; Woolley, I. J.

In: QJM, Vol. 112, No. 1, 01.01.2019, p. 17-21.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence of HIV indicator conditions in late presenting patients with HIV

T2 - a missed opportunity for diagnosis?

AU - Lin, Y. D.

AU - Garner, S. E.

AU - Lau, J. S.Y.

AU - Korman, T. M.

AU - Woolley, I. J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aim: To evaluate prior prevalence of HIV indicator conditions in late-presenters with HIV infection. Design: Retrospective cohort study between 2000 and 2014 in a healthcare network in Melbourne, Australia comparing patients presenting with late diagnosis of HIV infection (CD4 < 350 cells/ml) to those patients who had a CD greater than or equal to 350 cells/ml at presentation. Method: The European AIDS Clinical Society guidelines on HIV indicator guided testing were used to assess for any indicator conditions in their prior medical history which may have represented a missed opportunity for earlier diagnosis. Main outcome measures: Descriptive statistics and prevalence of HIV indicator conditions. Results: Of 436 patients with HIV infection, 82 were late presenters. Late presenters were more commonly male (83% vs. 75%, P = 0.11), older (mean age 45 vs. 39 years), born overseas (61% vs. 58%, P = 0.68) and report heterosexual transmission as their exposure risk (51% vs. 31%, P < 0.001). Of 80 patients with late presentation of HIV infection, 54 (55%) had at least one, 29 (36%) at least 2, 12 (15%) at least 3 and 5 (6%) had 4 or more previous HIV indicator conditions which would have triggered HIV testing according to guidelines. The most common indicator conditions were: unexplained loss of weight (31%), herpes zoster (10%), thrombocytopenia or leukopenia (10%), oral or oesophageal candidiasis (10%) and community acquired pneumonia (9%). Twenty patients (25%) had HIV indicator conditions diagnosed at least 12 months before the eventual diagnosis of HIV infection. Discussion/ Conclusion: Patients diagnosed with late-presenting HIV often had an HIV indicator condition prior to presentation, presenting a missed opportunity for earlier diagnosis.

AB - Aim: To evaluate prior prevalence of HIV indicator conditions in late-presenters with HIV infection. Design: Retrospective cohort study between 2000 and 2014 in a healthcare network in Melbourne, Australia comparing patients presenting with late diagnosis of HIV infection (CD4 < 350 cells/ml) to those patients who had a CD greater than or equal to 350 cells/ml at presentation. Method: The European AIDS Clinical Society guidelines on HIV indicator guided testing were used to assess for any indicator conditions in their prior medical history which may have represented a missed opportunity for earlier diagnosis. Main outcome measures: Descriptive statistics and prevalence of HIV indicator conditions. Results: Of 436 patients with HIV infection, 82 were late presenters. Late presenters were more commonly male (83% vs. 75%, P = 0.11), older (mean age 45 vs. 39 years), born overseas (61% vs. 58%, P = 0.68) and report heterosexual transmission as their exposure risk (51% vs. 31%, P < 0.001). Of 80 patients with late presentation of HIV infection, 54 (55%) had at least one, 29 (36%) at least 2, 12 (15%) at least 3 and 5 (6%) had 4 or more previous HIV indicator conditions which would have triggered HIV testing according to guidelines. The most common indicator conditions were: unexplained loss of weight (31%), herpes zoster (10%), thrombocytopenia or leukopenia (10%), oral or oesophageal candidiasis (10%) and community acquired pneumonia (9%). Twenty patients (25%) had HIV indicator conditions diagnosed at least 12 months before the eventual diagnosis of HIV infection. Discussion/ Conclusion: Patients diagnosed with late-presenting HIV often had an HIV indicator condition prior to presentation, presenting a missed opportunity for earlier diagnosis.

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U2 - 10.1093/qjmed/hcy223

DO - 10.1093/qjmed/hcy223

M3 - Article

VL - 112

SP - 17

EP - 21

JO - QJM

JF - QJM

SN - 1460-2725

IS - 1

ER -