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Abstract

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010–2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrolment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm3 or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm3 (interquartile range (IQR) 193–555/mm3), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02–1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85–0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.

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2015-11-26
2018-04-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2015.20.47.30070
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Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=The+late+presenters+working+group+in+COHERE+in+EuroCoord&option1=author&noRedirect=true" class="nonDisambigAuthorLink">The late presenters working group in COHERE in EuroCoord</a></span>. Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013. <a href="/content/ecdc">Euro Surveill.</a> 2015;20(47):pii=30070. <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.47.30070" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2015.20.47.30070</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 01 Sep 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Nov 2015 </span> </p>
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