scholarly journals Difficulties in primary diagnosis of HIV infection at the stages of health care settings

2020 ◽  
Vol 25 (1) ◽  
pp. 11-17
Author(s):  
Elena V. Esaulenko ◽  
Kseniya E. Novak ◽  
Thierry Ingabire ◽  
Sof’ya A. Semenova ◽  
Aleksandra O. Nikiforova
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Primary Care Physicians ◽  
Sexual Transmission ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Rapid Tests ◽  
First Time

Aim: to demonstrate the difficulties and timeliness of HIV diagnosis by primary care physicians, to carry out a clinical and epidemiological analysis of newly diagnosed cases of HIV infection. Materials and methods: The study evaluated the routing of diagnosis and analyzed the epidemiological and clinical and laboratory data of 85 patients with a newly diagnosed HIV infection hospitalized in the St. Petersburg Clinical Infectious Diseases Hospital named after S. P. Botkin during the period from November 2018 to October 2019. To confirm positive results, ELISA and western blot were used. Results: Among the observed patients, 71.3% were women and 28.7% were men. The average age was 39.3 2 years. Upon admission to the infectious diseases hospital with an established diagnosis of HIV infection, 49.5% were hospitalized in specialized departments (n = 42). Of them, nine (9) were referred by the polyclinic with an established diagnosis, in 20 patients the diagnosis was established in somatic hospitals, and emergency room doctors newly diagnosed HIV infection in 13 more patients. The remaining 50.5% (n = 43) were hospitalized in various departments with other diagnoses. Clinical and laboratory analysis of these patients showed that for the first time in life, an established diagnosis of HIV infection corresponded to both early (15.3%) and late (84.7%) stages of the disease with dominance of sexual transmission of the virus (43.6%). Conclusion: HIV infection at both early and late stages can manifest under the guise of various other diseases, which makes it necessary to expand testing of patients for HIV infection, including using rapid tests.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

scholarly journals The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Agustí ◽  
Núria Font-Casaseca ◽  
Francesc Belvis ◽  
Mireia Julià ◽  
Núria Vives ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Hiv Infection ◽  
Urban Areas ◽  
Western Europe ◽  
Hiv Infections ◽  
National Registry ◽  
Surveillance Data ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Incident Cases

Abstract Background Spatial visualization of HIV surveillance data could improve the planning of programs to address the HIV epidemic. The objectives of the study were to describe the characteristics and the spatial distribution of newly diagnosed HIV infection in Catalonia and to identify factors associated with HIV infection rates. Methods Surveillance data from the national registry were presented in the form of descriptive and ring maps and used to study the spatial distribution of new HIV diagnoses in Catalonia (2012–2016) and associated risk factors at the small area level (ABS, acronym for “basic health area” in Catalan). Incident cases were modeled using the following as predictors: type of municipality, prevalence of young men and migrant groups, GBMSM activity indicators, and other variables at the aggregated level. Results New HIV diagnoses are heterogeneously distributed across Catalonia. The predictors that proved to be significantly associated with a higher rate of new HIV diagnoses were ABS located in the city of Barcelona (IRR, 2.520; P < 0.001), a higher proportion of men aged 15–44 years (IRR, 1.193; P = 0.003), a higher proportion of GBMSM (IRR, 1.230; P = 0.030), a higher proportion of men from Western Europe (IRR, 1.281; P = 0.003), a higher proportion of men from Latin America (IRR, 1.260; P = 0.003), and a higher number of gay locations (IRR, 2.665; P < 0.001). No association was observed between the HIV diagnosis rate and economic deprivation. Conclusions Ring maps revealed substantial spatial associations for the rate of new HIV diagnoses. New HIV diagnoses are concentrated in ABS located in urban areas. Our results show that, in the case of HIV infection, the socioeconomic deprivation index on which the Catalan government bases its budget allocation policies among the ABS should not be the only criterion used.

scholarly journals Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259708
Author(s):  
Gallican N. Rwibasira ◽  
Samuel S. Malamba ◽  
Gentille Musengimana ◽  
Richard C. M. Nkunda ◽  
Jared Omolo ◽  
...  
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
National Level ◽  
Age Groups ◽  
Monitoring And Evaluation ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Epidemic Control ◽  
Hiv Diagnosis ◽  
Recent Infection

Background Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. Methods We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. Results Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). Conclusion Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.

Magnitude and Determinants of First-Time and Repeat Testing Among Individuals With Newly Diagnosed HIV Infection Between 2000 and 2001 in Alberta, Canada

2004 ◽  
Vol 37 (5) ◽  
pp. 1651-1656 ◽  
Author(s):  
Gayatri C. Jayaraman ◽  
Katherine R. Bush ◽  
Bonita Lee ◽  
Ameeta E. Singh ◽  
Jutta K. Preiksaitis
Keyword(s):  
Hiv Infection ◽  
Newly Diagnosed ◽  
Repeat Testing ◽  
First Time

scholarly journals History of syphilis in women living with AIDS and associated risk factors in São Paulo, Brazil

2014 ◽  
Vol 60 (4) ◽  
pp. 342-348 ◽  
Author(s):  
Valdir Monteiro Pinto ◽  
Mariza Vono Tancredi ◽  
Cassia Maria Buchalla ◽  
Angelica Espinosa Miranda
Keyword(s):  
Risk Factors ◽  
Sexual Transmission ◽  
Laboratory Data ◽  
Sao Paulo ◽  
Prior History ◽  
São Paulo ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
History Of ◽  
Associated Risk Factors

Objective: to describe the epidemiological profile, risk behaviors, frequency of prior history of syphilis in women living with AIDS and to investigate associated factors. Methods: a cross-sectional study conducted with women living with HIV attending at Reference Center for AIDS in São Paulo. Demographic, behavioral, and clinical data were analyzed based on medical records. Results: a total of 598 women were included in the study and the prevalence of previous syphilis was 6.2% (95% CI 4,3-8,1). Seventy-three percent of women were less than 40 years of age when diagnosed with AIDS and 49.6% had more than eight years of formal education. 67.2% were white and 65.9% were not married or living with a partner, 53.2% reported that their first sexual intercourse aged more than 15 years, 56.5% reported having only one partner in the last year and 13% reported drug use. Regarding laboratory data, 83.8% had CD4+ <500 cells/ mm3 upon diagnosis of AIDS. Previous syphilis was associated with the use of crack cocaine [AOR = 6.8 (95% CI 1.7 - 27.5)], >1 sexual partner in the last year [AOR = 6.6 (95% CI 1.2 - 37.1)], CD4 + <500 cells/mm3 [AOR = 3.8 (women 1.1 - 13.6)], HIV diagnosis > 8 years [AOR = 2.4 (95% CI 1.0 - 5.8)]. Conclusion: a high prevalence of previous syphilis was found in the population studied, and crack use was identified among the main associated risk factors. Interventions to reduce the risk of sexual transmission of HIV and syphilis must be strengthened, with the implementation of control actions, screening strategies, early diagnosis and treatment, preventing complications, reducing morbidity and improving sexual and reproductive health.

scholarly journals CLINICAL AND LABORATORY CHARACTERISTICS HIV-INFECTED PATIENTS WITH NEWLY DIAGNOSED KAPOSI’S SARCOMA

2019 ◽  
Vol 11 (1) ◽  
pp. 53-57
Author(s):  
V. D. Renev ◽  
D. A. Lioznov ◽  
O. N. Leonova ◽  
A. V. Nekrasova ◽  
T. V. Antonova
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Kaposi's Sarcoma ◽  
Laboratory Data ◽  
Kaposi’S Sarcoma ◽  
Skin Lesions ◽  
Antiretroviral Drugs ◽  
Hospital Death ◽  
Newly Diagnosed ◽  
Cd4 Lymphocytes

Objective: to characterize the clinical and laboratory parameters of patients with HIV infection with newly diagnosed Kaposi’s sarcoma.Materials and methods. The analysis of clinical and laboratory data of 25 HIV-infected patients with newly diagnosed Kaposi’s sarcoma who were treated in the in-patient department of St. Petersburg Center for the Prevention and Control of AIDS and Infectious Diseases in 2009-2017Results. Ninety-two (n=23) patients were men. The median age at detecting HIV infection is 36 years. The manifestation age of Kaposi’s sarcoma is a median of 37 years. Elements of Kaposi’s sarcoma were located mainly on the skin of the lower and upper extremities, trunk, face and oral mucosa. Manifest CMV infection was registered in one patient, candidiasis of various localizations was found in 19 patients (76%), 2 of them also had one case of tuberculosis and toxoplasmosis. The viral load of HIV in the serum of patients upon admission to the hospital ranged from 26 159 to 2 755,549 copies/ml. The number of CD4 lymphocytes in the serum of patients is from 4 to 674 cells/μl. First-line antiretroviral drugs were prescribed to 20 (80%) patients, while the positive dynamics of sarcoma was observed in 8 patients. Four (16%) patients received antitumor treatment. The duration of hospitalization of patients ranged from 8 to 85 days (median 29). Twenty-one patients were discharged from the hospital, death was registered in 4 patients (16%).Conclusion. Characteristics of patients with HIV infection with newly diagnosed Kaposi’s sarcoma are: the predominance of males aged 30-39 years; skin lesions of the limbs and trunk in the debut of the clinical picture of sarcoma; laboratory signs of pronounced immunodeficiency (in 75% of patients, CD4 lymphocytes in the serum are less than 200 cells/μl); high viral load of HIV in serum (in 88% of patients more than 100 000 copies/ml); frequent combination with other opportunistic diseases.

scholarly journals The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain).

2020 ◽  
Author(s):  
Cristina Agusti ◽  
Núria Font-Casaseca ◽  
Francesc Belvis ◽  
Mireia Julià ◽  
Núria Vives ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Hiv Infection ◽  
Urban Areas ◽  
Western Europe ◽  
Hiv Infections ◽  
National Registry ◽  
Surveillance Data ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Incident Cases

Abstract Background: Spatial visualization of HIV surveillance data could improve the planning of programs to address the HIV epidemic. The objectives of the study were to describe the characteristics and the spatial distribution of newly diagnosed HIV infection in Catalonia and to identify factors associated with HIV infection rates.Methods: Surveillance data from the national registry were presented in the form of descriptive and ring maps and used to study the spatial distribution of new HIV diagnoses in Catalonia (2012-2016) and associated risk factors at the small area level (ABS, acronym for “basic health area” in Catalan). Incident cases were modeled using the following as predictors: type of municipality, prevalence of young men and migrant groups, MSM activity indicators, and other variables at the aggregated level. Results: New HIV diagnoses are heterogeneously distributed across Catalonia. The predictors that proved to be significantly associated with a higher rate of new HIV diagnoses were ABS located in the city of Barcelona (IRR, 2.520; P<0.001), a higher proportion of men aged 15-44 years (IRR, 1.193; P=0.003), a higher proportion of MSM (IRR, 1.230; P=0.030), a higher proportion of men from Western Europe (IRR, 1.281; P=0.003), a higher proportion of men from Latin America (IRR, 1.260; P=0.003), and a higher number of gay locations (IRR, 2.665; P<0.001). No association was observed between the HIV diagnosis rate and economic deprivation.Conclusions: Ring maps revealed substantial spatial associations for the rate of new HIV diagnoses. New HIV diagnoses are concentrated in ABS located in urban areas. Our results show that, in the case of HIV infection, the socioeconomic deprivation index on which the Catalan government bases its budget allocation policies among the ABS should not be the only criterion used.

scholarly journals Increasing prevalence of HIV infection among first time clients in Italian drug treatment services – is it sexual transmission?

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Mario Cruciani ◽  
Lucas Wiessing ◽  
Giovanni Serpelloni ◽  
Bruno Genetti ◽  
Alessandra Andreotti ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Drug Treatment ◽  
Sexual Transmission ◽  
Treatment Services ◽  
First Time

scholarly journals Abdominal neoplasia with sarcomatoid features as the presenting illness of a patient with a newly diagnosed HIV infection and no AIDS-related disorders. Case report, clinical and diagnostic features, and literature discussion

2014 ◽  
Vol 8 (4) ◽  
pp. 115-120
Author(s):  
Roberto Manfredi ◽  
Sergio Sabbatani ◽  
Eleonora Magistrelli ◽  
Maria Lucia Tardio
Keyword(s):  
Case Report ◽  
Hiv Infection ◽  
Solid Tumors ◽  
Abdominal Mass ◽  
Diagnostic Workup ◽  
Literature Discussion ◽  
Newly Diagnosed ◽  
Diagnostic Features ◽  
Poorly Differentiated ◽  
First Time

We aim to describe a patient with an already advanced HIV infection disclosed for the first time during a complex diagnostic workup, which detected a gross abdominal mass attributable to a poorly differentiated mesenchymal cancer with sarcomatoid features which rapidly led our patient to death, in absence of other potential HIV-associated opportunistic diseases. Although extremely rare and rapidly lethal, our case report underscores the need of all caregivers who follow HIV-infected patients also in the cART era to maintain an elevated attention toward infrequent, unexpected, and clinically atypical solid tumors, in order to ensure a timely diagnosis and management when possible.

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