Impact of coronavirus pandemic and containment measures on HIV diagnosis

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Abstract

During the last months and following the implementation of containment measures in the context of coronavirus disease 2019 (COVID-19) pandemic, the number of new human immunodeficiency virus (HIV) diagnoses radically decreased in Liege AIDS Reference Center, Belgium. The number of HIV screening tests has also dramatically dropped down to an unprecedented level. This decline of HIV diagnosis is caused by missed diagnoses of individuals infected before the establishment of such measures and to the reduction of high-risk sexual behaviours during the COVID-19 pandemic.

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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

Amanda Mocroft, Jens D Lundgren, Andrea Antinori … (2015)

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 enrollment) 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/mm(3) 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/mm(3) (interquartile range (IQR) 193-555/mm(3)), 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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Factors associated with late presentation for HIV care in a single Belgian reference center: 2006–2017

Gilles Darcis, Iseult Lambert, Anne-Sophie Sauvage … (2018)

Late presentation for HIV care is a major issue and the cause of higher morbidity, mortality and transmission. In this regard, we analyzed the characteristics of patients presenting for care at our center from January 2006 to July 2017 (n = 687). The majority of the studied population was of African origin (54.3%) with heterosexual women representing the main group (n = 292; 42.5%). 44% of the patients were late presenters (LP) (presenting for care with CD4 T cells <350/mm3 or an AIDS defining event) and 24% were late presenters with advanced disease (LP-AD) (presenting for care with CD4 T cells <200/mm3 or an AIDS defining event). A very high risk of being LP and LP-AD was associated with Sub-Saharan origin (OR 3.4 and 2.6 respectively). Other factors independently associated with LP or LP-AD were age (OR 1.3), male gender (OR 2.0 and 1.5 respectively) and heterosexual route of transmission (OR 2.4 and 2.3 respectively). A significant increase in HIV screening without forgetting those groups would contribute to earlier HIV diagnosis, a key element to end the HIV epidemic. To achieve this goal, addressing the specific hurdles to HIV testing in the migrant population is critical.

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Author and article information

Journal

Journal ID (nlm-ta): Epidemiol Infect

Journal ID (iso-abbrev): Epidemiol. Infect

Journal ID (publisher-id): HYG

Title: Epidemiology and Infection

Publisher: Cambridge University Press (Cambridge, UK )

ISSN (Print): 0950-2688

ISSN (Electronic): 1469-4409

Publication date (Electronic, collection): 2020

Publication date (Electronic, pub): 24 August 2020

Volume: 148

Electronic Location Identifier: e185

Affiliations

[1 ]Infectious Diseases Department, Liège University Hospital , Liège, Belgium

[2 ]AIDS Reference Laboratory, Liège University , Liège, Belgium

Author notes

Author for correspondence: Gilles Darcis, E-mail: gdarcis@ 123456chuliege.be

Author information

Gilles Darcis https://orcid.org/0000-0001-8192-1351

Article

Publisher Item ID: S0950268820001867

DOI: 10.1017/S0950268820001867

PMC ID: 7463155

PubMed ID: 32829742

SO-VID: 8b9df57d-23d6-4221-a711-cc3f8adbc6a8

License:

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 27 July 2020

Date revision received : 11 August 2020

Date accepted : 18 August 2020

Page count

Tables: 1, References: 2, Pages: 2

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