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Associations of HIV testing and late diagnosis at a Japanese university hospital
Horino, Tetsuya; Sato, Fumiya; Kato, Tetsuro; Hosaka, Yumiko; Shimizu, Akihiro; Kawano, Shinji; Hoshina, Tokio; Nakaharai, Kazuhiko; Nakazawa, Yasushi; Yoshikawa, Koji; Yoshida, Masaki; Hori, Seiji.
Afiliação
  • Horino, Tetsuya; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Sato, Fumiya; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Kato, Tetsuro; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Hosaka, Yumiko; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Shimizu, Akihiro; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Kawano, Shinji; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Hoshina, Tokio; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Nakaharai, Kazuhiko; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Nakazawa, Yasushi; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Yoshikawa, Koji; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Yoshida, Masaki; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
  • Hori, Seiji; Jikei University School of Medicine. Department of Infectious Diseases and Infection Control. Tokyo. JP
Clinics ; 71(2): 73-77, Feb. 2016. tab, graf
Article em En | LILACS | ID: lil-774530
Biblioteca responsável: BR1.1
ABSTRACT

OBJECTIVES:

This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis.

METHODS:

This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed.

RESULTS:

A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell count <350/mm3) and very late (CD4 cell count <200/mm3) diagnoses were observed in 61.4% (282/459) and 36.6% (168/459) of patients, respectively. The most common reason for HIV diagnosis was voluntary testing (38.6%, 177/459 patients), followed by AIDS-defining illness (18.3%, 84/459 patients). Multivariate analysis revealed a significant association of voluntary HIV testing with non-late and non-very-late diagnoses and there was a high proportion of AIDS-defining illness in the late and very late diagnosis groups compared with other groups. Men who have sex with men was a relative factor for non-late diagnosis, whereas nonspecific abnormal blood test results, such as hypergammaglobulinemia and thrombocytopenia, were risk factors for very late diagnosis.

CONCLUSIONS:

Voluntary HIV testing should be encouraged and physicians should screen all patients who have symptoms or signs and particularly hypergammaglobulinemia and thrombocytopenia, that may nonspecifically indicate HIV infection.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Comportamentos Relacionados com a Saúde / Infecções por HIV / Diagnóstico Tardio / Hipergamaglobulinemia Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male País/Região como assunto: Asia Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Japão País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Comportamentos Relacionados com a Saúde / Infecções por HIV / Diagnóstico Tardio / Hipergamaglobulinemia Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male País/Região como assunto: Asia Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Japão País de publicação: Brasil