A. Vâţă 1, Carmen Manciuc 1, Cristina Nicolau 2, L. Prisăcariu 2, Luminiţa Vâţă 1, Carmen Dorobăţ 1
1 University of Medicine and Pharmacy “Gr. T. Popa” Iaşi
2 Regional HIV/AIDS Center of Iaşi
Abstract
Late diagnosis of HIV infection has unfavorable repercussions on both the patients themselves, due to higher morbidity and mortality rates, and the society as a whole, given the higher infection transmission risks and increased therapy and recovery costs. Material and methods. Our paper tackles a retrospective study conducted on naïve patients that have entered the records of the Regional HIV/AIDS Center of Iaşi in the last 10 years (2001-2010), based on the initial clinical, laboratory and therapeutic data found in the follow-up records of these patients. Late diagnosis was established when the patient presented for care with a CD4 count below 350 cells/mL or having an AIDS-defining condition. Results. 73.4% of the 192 patients included in the study were considered late presenters (58.5% with advanced HIV infection), according to the latest consensus definition. The average age of late presenters was 23.7 years, 53.9% of them being born between 1988 and 1991; M/F ratio – 1.3, U/R ratio – 1.14, average CD4 number – 130.8/cmm. The factors usually associated with late diagnosis in literature (age over 30 years, males, hepatitis co-infection) had no statistical significance in our study group. Mortality rates were considerably higher in late presenters (31.9 vs. 7.8%, p=0.002) and were correlated with a low initial number of CD4 (p<0.001), younger age (p=0.004); 57.8% of the deaths occurred within 6 months from diagnosis. ARV therapy was started by combining 2 NRTIs and PI in 52.7% of the patients, 2 NRTIs and one NNRTI in 32.1% of them, while raltegravir was only used in 3 patients. Conclusions. late diagnosis rates were higher in Iaşi County than in literature, while the risk factors detected by other authors had no statistical significance, possibly due to the regional epidemiological specificity.