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Late Presenters of HIV Infection in an HIV Unit of a Tertiary University Hospital in a Rural Region of Greece.
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2020-07-02 , DOI: 10.1089/aid.2019.0246
Vasileios Petrakis 1 , Periklis Panagopoulos 1 , Tzelal Maltsan 1 , Anna-Maria Xanthopoulou 1 , Irene Terzi 1 , Nikolaos Papanas 1 , Efstratios Maltezos 1 , Dimitrios Papazoglou 1
Affiliation  

A significant progress has been made over the years in the prognosis and treatment of patients with early diagnosis of HIV infection. However, late presentation of a large number of patients remains a serious public health problem. The aim of our study is to highlight the dimensions of the problem by evaluating the data from the HIV Unit of Alexandroupolis, a rural region with population heterogeneity and a strategic position between West and East, Europe, and Asia. This was a retrospective study, including 107 patients diagnosed with HIV infection in our unit from 2010 to 2018. Late presenters (LP) were defined as patients diagnosed with a CD4 cell count <350/mm3 or an AIDS-defining condition regardless of CD4 cell count. The proportion of patients diagnosed late was 49.5%. The majority were males in the age group 31–40 years (41.5%). Men who had sex with men were 37.8%. Among LP, 34% were at Center for Disease Prevention and Control stage C3. The most common AIDS-defining condition observed was Pneumocystis jirovecii Pneumonia (15.1%), followed by esophageal candidiasis (7.5%) and cryptococcal meningitis (3.8%). In addition, immune reconstitution inflammatory syndrome was documented (3.8%). A high percentage of patients were also coinfected with hepatitis B (22.6%) virus. The notably high percentage of LP in our unit demonstrates that late presentation remains a challenge for public health. Further efforts must be made to ensure an early diagnosis of HIV infection. The early initiation of antiretroviral therapy is vital to reduce viral load to undetectable levels and the risk of HIV transmission.

中文翻译:

在希腊农村地区的第三大学医院的一个艾滋病科中,艾滋病毒感染的最新报道。

多年来,在早期诊断为HIV感染的患者的预后和治疗方面取得了重大进展。但是,大量病人的迟到仍然是一个严重的公共卫生问题。我们研究的目的是通过评估亚历山德鲁波利斯(Alexandroupolis)HIV部门的数据来突出问题的严重性,亚历山德鲁波利斯(Alexandroupolis)是一个人口异质化,在东西方,欧洲和亚洲之间处于战略地位的农村地区。这是一项回顾性研究,包括从2010年到2018年在我们单位中诊断为HIV感染的107例患者。晚期呈报者(LP)定义为诊断为CD4细胞计数<350 / mm 3的患者或定义艾滋病的状况,而与CD4细胞计数无关。被诊断为晚期的患者比例为49.5%。大多数是年龄在31至40岁之间的男性(41.5%)。与男性发生性关系的男性为37.8%。在LP中,34%处于疾病预防控制中心C3阶段。观察到的最常见的艾滋病定义病是吉氏肺孢子虫肺炎(15.1%),其次是食道念珠菌病(7.5%)和隐球菌性脑膜炎(3.8%)。此外,免疫重建性炎症综合症也有记录(3.8%)。很大一部分患者还同时感染了乙型肝炎病毒(22.6%)。在我们单位中,LP的比例非常高,这表明后期演示仍然是公共卫生的挑战。必须做出进一步的努力以确保及早诊断出HIV感染。尽早开始抗逆转录病毒疗法对于将病毒载量降至无法检测的水平以及降低HIV传播风险至关重要。
更新日期:2020-07-03
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