Late diagnosis of HIV infection in a center from the metropolitan area of Buenos Aires

Keywords: HIV, late diagnosis, advanced disease, opportunistic events, BAMA

Abstract

Background: Late diagnosis of HIV is defined as a CD4 + T cell count below 350/mm3 and/or associated with a WHO stage 2 opportunistic event. Advanced disease represents the subgroup of people with counts below 200 CD4 + T lymphocytes/mm3 and/or with WHO stage 3 and 4 events. In Argentina, 45% of new HIV diagnoses are late, including 29% of patients with advanced disease. This work was carried out to characterize HIV late diagnosis during the period 2018-2021 in a reference center in the Buenos Aires Metropolitan Area (BAMA), Argentina.

Patients and methods: Descriptive, observational, cross-sectional study that included people over 18 years of age with a diagnosis of HIV infection (PLHIV) between January 1, 2018, and December 31, 2021.

Results: 1116 PLHIV were included, of which 50% (n= 558) had late diagnosis and 27% (n= 301) had advanced disease. Thirty percent (n= 90) of people with advanced disease had an opportunistic event, the most frequent being Pneumocystis jirovecii pneumonia, tuberculosis and esophageal candidiasis.

Conclusions: The late diagnosis of HIV infection continues to be a frequent problem, representing half of new HIV diagnoses in our center. It is necessary to implement actions to improve access to diagnosis and ART.

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Author Biographies

Diego Cecchini

Helios Salud, Ciudad Autónoma de Buenos Aires, Argentina.

Laura Pérez Martínez

Centro de Investigaciones Biomédicas de La Rioja (CIBIR), La Rioja, España.

Isabel Cassetti

Helios Salud, Ciudad Autónoma de Buenos Aires, Argentina.

Rosa Polo

Universidad Rey Juan Carlos, Madrid, España.

References

BIBLIOGRAFÍA:
1. Últimas estadísticas sobre el estado de la epidemia de sida. [último acceso el 2 de diciembre de 2023]. Disponible en: https://www.unaids.org/es/resources/fact-sheet
2. Banco de Recursos de Comunicación del Ministerio de Salud de la Nación. [último acceso el 2 de diciembre de 2023]. Available: https://bancos.salud.gob.ar/recurso/sintesis-boletin-n-40-de-respuesta-al-vih-y-las-its-en-la-argentina
3. Definición de la OMS de caso de infección por el VIH a efectos de vigilancia y revisión de la estadificación clínica y de la clasificación inmunológica de la enfermedad relacionada con el VIH en adultos y niños; 2009. [último acceso el 4 de febrero de 2024]. Disponible en: https://www.paho.org/es/documentos/definicion-oms-caso-infeccion-por-vih-efectos-vigilancia-revision-estadificacion-clinica
4. Sobrino-Vegas P, Moreno S, Rubio R, Viciana P, Bernardino J, Blanco J, et al. Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort: 2004-2013. J Infect. 2016;72: 587–596.
5. Popping S, Versteegh L, Nichols BE, van de Vijver DAMC, van Sighem A, Reiss P, et al. Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands. PLoS One. 2023;18: e0280877.
6. Krentz HB, Auld MC, Gill MJ. The high cost of medical care for patients who present late (CD4 <200 cells/microL) with HIV infection. HIV Med. 2004;5: 93–98.
7. Zoufaly A, an der Heiden M, Marcus U, Hoffmann C, Stellbrink H, Voss L, et al. Late presentation for HIV diagnosis and care in Germany. HIV Med. 2012;13: 172–181.
8. Muelas Fernandez M, Rojas Lievano JF, Perez Vidal R, Flor Pérez A, Tapiz Reula A, Mallolas Masferrer J. Prevalence of late diagnosis of HIV infection. Med Clin . 2020;155: 388–391.
9. Crabtree-Ramírez B, Caro-Vega Y, Shepherd B, Grinsztejn B, Wolff M, Cortes C, et al. Time to HAART Initiation after Diagnosis and Treatment of Opportunistic Infections in Patients with AIDS in Latin America. PLoS One. 2016;11: e0153921.
10. Arantes L, Pedroso A, Menegueti M, Gir E, Botelho E, Silva A, et al. Factors Associated with Late Diagnosis of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in a University Hospital in Brazil: Challenges to Achieving the 2030 Target. Viruses. 2023;15. doi:10.3390/v15102097
11. Ribeiro L, Freitas M, Tupinambás U, Lana F. Late diagnosis of Human Immunodeficiency Virus infection and associated factors. Rev Lat Am Enfermagem. 2020;28: e3342.
12. Severin S, Delforge M, De Wit S. Epidemiology, comorbidities at diagnosis and outcomes associated with HIV late diagnosis from 2010 to 2019 in a Belgian reference center: A retrospective study. HIV Med. 2022;23: 1184–1194.
13. EACS Guidelines. Último acceso el 4 de febrero de 2024. Disponible en: https://www.eacsociety.org/guidelines/eacs-guidelines/
14. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Fecha de última consulta: 30 de enero de 2024. Disponible en: https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv.
15. Sociedad Argentina de Infectología. Consenso Argentino de Terapia Antirretroviral : versión 8.0 Diciembre 2023 / 8a ed. Fecha de última consulta: 30 de enero de 2024. Disponible en https://www.sadi.org.ar/publicaciones/item/1733-consenso-argentino-de-terapia-antirretroviral
Published
2025-02-26
How to Cite
Brizuela, M., Cecchini, D., Pérez Martínez, L., Cassetti, I., & Polo, R. (2025). Late diagnosis of HIV infection in a center from the metropolitan area of Buenos Aires . Actualizaciones En Sida E Infectología, 33(117). https://doi.org/10.52226/revista.v33i117.299
Section
Brief communication