Abstract

Late presentation to healthcare by HIV infected patients' is common in India despite access to free combination antiretroviral therapy (cART). We assessed risk factors for late presentation among patients with a recent HIV diagnosis in an academic university-based antiretroviral treatment center. This retrospective study included 474 recently diagnosed HIV-infected patients registered for cART between 2012 and 2013. Subjects with CD4+ T-lymphocyte (CD4) count ≤350 cells/μL or with an AIDS defining event were defined as late presenters (LP) and patients with CD4 count ≤200 cells/μL or with an AIDS defining event were defined as LP with advanced HIV disease (LPAD). Multivariable logistic regression analysis was used to investigate factors associated with late presentation. Of the 474 patients, 356 (75.1%) were LP. Of these, 299 (83.99%) were LPAD and 57 (16.01%) LP were AIDS-free. Median CD4 count among LP was 134 cells/μL (interquartile range 72.25-219). Mean age of LP was 42.50 ± 8.88 years; 256 (71.9%) were males. Increasing age (> 51 years; Adjusted odds ratio [aOR] 4.19; P = 0.014) and rural residence (aOR 3.19; P = < 0.001) were independently associated with late presentation. HIV-positive housewives (aOR 0.34; P = 0.027), HIV-positive individuals with negative partners (aOR 0.48; P =0.006), and partners with unknown HIV status (aOR 0.43; P = 0.007) were less likely topresent late compared with positive partners of people living with HIV/AIDS (PLWHA). Most patients were LP despite free access to cART. Rural population and older PLWHA should be targeted while implementing HIV care. There is a need to strengthen the HIV care cascade by linking PLWHA to cART immediately after diagnosis.

Original languageEnglish
Pages (from-to)1331-1335
Number of pages5
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume99
Issue number5
DOIs
Publication statusPublished - 01-01-2018

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HIV
Acquired Immunodeficiency Syndrome
Odds Ratio
CD4 Lymphocyte Count
Therapeutics
Lymphocyte Count
Rural Population
India
Retrospective Studies
Logistic Models
Regression Analysis
Delivery of Health Care
T-Lymphocytes

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

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title = "Correlates of late presentation to HIV care in a South Indian Cohort",
abstract = "Late presentation to healthcare by HIV infected patients' is common in India despite access to free combination antiretroviral therapy (cART). We assessed risk factors for late presentation among patients with a recent HIV diagnosis in an academic university-based antiretroviral treatment center. This retrospective study included 474 recently diagnosed HIV-infected patients registered for cART between 2012 and 2013. Subjects with CD4+ T-lymphocyte (CD4) count ≤350 cells/μL or with an AIDS defining event were defined as late presenters (LP) and patients with CD4 count ≤200 cells/μL or with an AIDS defining event were defined as LP with advanced HIV disease (LPAD). Multivariable logistic regression analysis was used to investigate factors associated with late presentation. Of the 474 patients, 356 (75.1{\%}) were LP. Of these, 299 (83.99{\%}) were LPAD and 57 (16.01{\%}) LP were AIDS-free. Median CD4 count among LP was 134 cells/μL (interquartile range 72.25-219). Mean age of LP was 42.50 ± 8.88 years; 256 (71.9{\%}) were males. Increasing age (> 51 years; Adjusted odds ratio [aOR] 4.19; P = 0.014) and rural residence (aOR 3.19; P = < 0.001) were independently associated with late presentation. HIV-positive housewives (aOR 0.34; P = 0.027), HIV-positive individuals with negative partners (aOR 0.48; P =0.006), and partners with unknown HIV status (aOR 0.43; P = 0.007) were less likely topresent late compared with positive partners of people living with HIV/AIDS (PLWHA). Most patients were LP despite free access to cART. Rural population and older PLWHA should be targeted while implementing HIV care. There is a need to strengthen the HIV care cascade by linking PLWHA to cART immediately after diagnosis.",
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Correlates of late presentation to HIV care in a South Indian Cohort. / Rao, Satish; Satheesh, A. V.; Unnikrishnan, Bhaskaran; Madi, Deepak; Shetty, Avinash K.

In: American Journal of Tropical Medicine and Hygiene, Vol. 99, No. 5, 01.01.2018, p. 1331-1335.

Research output: Contribution to journalArticle

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