Associations of HIV testing and late diagnosis at a Japanese university hospital
Clinics
;
71(2): 73-77, Feb. 2016. tab, graf
Article
in English
| LILACS
| ID: lil-774530
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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Health Behavior
/
HIV Infections
/
Delayed Diagnosis
/
Hypergammaglobulinemia
Type of study:
Diagnostic study
/
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2016
Type:
Article
Affiliation country:
Japan
Institution/Affiliation country:
Jikei University School of Medicine/JP
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