Login Register Cart 0
Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Late Diagnosis at Entry on Care in an HIV Clinic in Mexico City: Possibly COVID-19 Pandemic Impact

Author(s): Cesar Ivan Elizalde-Barrera* and Carlos Virgilio Juarez-Mendoza

Volume 21, Issue 4, 2023

Published on: 22 September, 2023

Page: [248 - 253] Pages: 6

DOI: 10.2174/1570162X21666230717150555

Price: $65

Abstract

Background: HIV late-stage diagnoses have an important impact on mortality. Unfortunately, a significant number of patients are still diagnosed at late stages. On the other hand, the coronavirus disease 2019 (COVID-19) pandemic has created an unprecedented crisis in healthcare systems worldwide, including HIV care services.

The aim of this study was to compare time-trends in HIV late diagnosis, prevalence, and initial CD4 cell counts of newly diagnosed HIV-positive individuals at the entry to HIV care in a General Hospital in Mexico City and to assess the Covid-19 pandemic possible effects on late diagnosis prevalence.

Methods: We retrospectively analyzed the data of HIV-infected patients (January 1999 to December 2021) to assess the prevalence of Late presentation (LP, CD4 count < 350 cells/mm3) and presentation with advanced HIV disease (AHIVD CD4 count < 200 cells/mm3). Differences across time were evaluated, focusing on years of the Covid-19 pandemic.

Results: We included 348 newly diagnosed HIV-positive individuals, of which 255 (73.2%) patients entered into care with LP, and 158 (45.4%) were on AHIVD. The proportion of patients with LP and AHIVD decreased significantly across the study period. Nevertheless, we found an increase in this proportion in the years 2020 (70% and 53%) and 2021 (86% and 68%).

Conclusion: Despite the progressive decrease in late diagnosis prevalence in our population, it remains high. Even more, our results documented a possible increase in the prevalence of late diagnosis associated with the COVID-19 pandemic. These findings highlight the need to prioritize interventions to evaluate and reverse pandemic effects on people living with HIV care.

Keywords: HIV, Covid-19, late presentation, Mexico, advanced HIV disease, diagnosis.

« Previous Next »
Graphical Abstract

[1]
Panos G, Samonis G, Alexiou V, Kavarnou G, Charatsis G, Falagas M. Mortality and morbidity of HIV infected patients receiving HAART: A cohort study. Curr HIV Res 2008; 6(3): 257-60.
[http://dx.doi.org/10.2174/157016208784324976] [PMID: 18473789]
[2]
Lundgren JD, Babiker AG, Gordin F, et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med 2015; 373(9): 795-807.
[http://dx.doi.org/10.1056/NEJMoa1506816] [PMID: 26192873]
[3]
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365(6): 493-505.
[http://dx.doi.org/10.1056/NEJMoa1105243] [PMID: 21767103]
[4]
Egger M, May M, Chêne G, et al. Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: A collaborative analysis of prospective studies. Lancet 2002; 360(9327): 119-29.
[http://dx.doi.org/10.1016/S0140-6736(02)09411-4] [PMID: 12126821]
[5]
Falster K, Petoumenos K, Chuah J, et al. Poor baseline immune function predicts an incomplete immune response to combination antiretroviral treatment despite sustained viral suppression. J Acquir Immune Defic Syndr 2009; 50(3): 307-13.
[http://dx.doi.org/10.1097/QAI.0b013e3181945ed4] [PMID: 19194311]
[6]
Elizalde-Barrera CI, Juárez-Mendoza CV, Maliachi-Díaz A, Rosado-Arenas IA, Sandoval-Ocampo S, Tinoco-Montes LE. Prevalence of impaired fasting glucose and dyslipidemia among Mexican HIV antiretroviral-naïve patients. Cir Cir 2023; 91(1): 100-6.
[http://dx.doi.org/10.24875/CIRU.21000594] [PMID: 36787610]
[7]
Hutchinson AB, Farnham PG, Duffy N, et al. Return on public health investment: CDC’s Expanded HIV Testing Initiative. J Acquir Immune Defic Syndr 2012; 59(3): 281-6.
[http://dx.doi.org/10.1097/QAI.0b013e31823e5bee] [PMID: 22067662]
[8]
Zhao T, Xuan K, Uy JP, Sun C. In the shadow of COVID‐19: HIVinfected individuals need more attention. J Med Virol 2021; 93(2): 611-1.
[http://dx.doi.org/10.1002/jmv.26378] [PMID: 32735365]
[9]
Avila-Ponce de León U, Pérez ÁGC, Avila-Vales E. An SEIARD epidemic model for COVID-19 in Mexico: Mathematical analysis and state-level forecast. Chaos Solitons Fractals 2020; 140110165.
[http://dx.doi.org/10.1016/j.chaos.2020.110165] [PMID: 32834649]
[10]
Antinori A, Coenen T, Costagiola D, et al. Late presentation of HIV infection: A consensus definition. HIV Med 2011; 12(1): 61-4.
[http://dx.doi.org/10.1111/j.1468-1293.2010.00857.x] [PMID: 20561080]
[11]
Wilton J, Light L, Gardner S, et al. Late diagnosis, delayed presentation and late presentation among persons enrolled in a clinical HIV cohort in Ontario, Canada (1999-2013). HIV Med 2019; 20(2): 110-20.
[http://dx.doi.org/10.1111/hiv.12686] [PMID: 30430742]
[12]
Darcis G, Lambert I, Sauvage AS, et al. Factors associated with late presentation for HIV care in a single Belgian reference center: 2006–2017. Sci Rep 2018; 8(1): 8594.
[http://dx.doi.org/10.1038/s41598-018-26852-0] [PMID: 29872068]
[13]
Karaosmanoğlu HK, Mete B, Gündüz A. Late presentation among patients with human immunodeficiency virus infection in Turkey. Cent Eur J Public Health. 2019; 27: pp. (3)229-34.
[http://dx.doi.org/10.21101/cejph.a5416] [PMID: 31580559]
[14]
Gesesew HA, Ward P, Woldemichael K, Mwanri L. Late presentation for HIV care in Southwest Ethiopia in 2003–2015: prevalence, trend, outcomes and risk factors. BMC Infect Dis 2018; 18(1): 59.
[http://dx.doi.org/10.1186/s12879-018-2971-6] [PMID: 29378523]
[15]
Hu X, Liang B, Zhou C, et al. HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: A large-scale cross-sectional study. AIDS Res Ther 2019; 16(1): 6.
[http://dx.doi.org/10.1186/s12981-019-0221-7] [PMID: 30876476]
[16]
Hernández-Romieu AC, del Rio C, Hernández-Ávila JE, et al. CD4 counts at entry to HIV care in Mexico for patients under the “universal antiretroviral treatment program for the uninsured population,” 2007–2014. PLoS One 2016; 11(3): e0152444.
[http://dx.doi.org/10.1371/journal.pone.0152444] [PMID: 27027505]
[17]
Carrizosa CM, Blumberg EJ, Hovell MF, et al. Determinants and prevalence of late HIV testing in Tijuana, Mexico. AIDS Patient Care STDS 2010; 24(5): 333-40.
[http://dx.doi.org/10.1089/apc.2009.0138] [PMID: 20438374]
[18]
Crabtree-Ramírez B, Caro-Vega Y, Belaunzarán-Zamudio F, Sierra-Madero J. High prevalence of late diagnosis of HIV in Mexico during the HAART era. Salud Publica Mex 2012; 54(5): 506-14.
[http://dx.doi.org/10.1590/S0036-36342012000500007] [PMID: 23011502]
[19]
Juárez Figueroa LA, Uribe-Salas FJ, González-Rodríguez A, Iracheta-Hernández P, Ruiz-González V, Medina-Islas Y. Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City. Salud Publica Mex 2017; 59(2): 147-53.
[http://dx.doi.org/10.21149/8072] [PMID: 28562715]
[20]
Villafuerte García A, Magis-Rodríguez CL, Cruz-Flores RA, Uribe-Zúñiga P. Late initiation of antiretroviral therapy in Mexico. Salud Publica Mex 2015; 57(S2): 127.
[http://dx.doi.org/10.21149/spm.v57s2.7600] [PMID: 26545128]
[21]
Mugavero MJ, Castellano C, Edelman D, Hicks C. Late diagnosis of HIV infection: The role of age and sex. Am J Med 2007; 120(4): 370-3.
[http://dx.doi.org/10.1016/j.amjmed.2006.05.050] [PMID: 17398235]
[22]
Skarbinski J, Rosenberg E, Paz-Bailey G, et al. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med 2015; 175(4): 588-96.
[http://dx.doi.org/10.1001/jamainternmed.2014.8180] [PMID: 25706928]
[23]
Rurangirwa J, Bingham TA, Kim J, Hu YW, Bing EG. Late HIV detection among adult males in Los Angeles County, 2000–2004. AIDS Care 2013; 25(4): 481-7.
[http://dx.doi.org/10.1080/09540121.2012.712670] [PMID: 22881055]
[24]
Walker PGT, Whittaker C, Watson OJ, Baguelin M, Winskill P, Hamlet A. The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries. Science 2020; 369: 413-22.
[http://dx.doi.org/10.1126/science.abc0035]
[25]
Celesia BM, Castronuovo D, Pinzone MR, et al. Late presentation of HIV infection: predictors of delayed diagnosis and survival in Eastern Sicily. Eur Rev Med Pharmacol Sci 2013; 17(16): 2218-24.
[PMID: 23893189]
[26]
WHO. Disruption in HIV, Hepatitis and STI services due to COVID-19. Available from: https://www.who.int/docs/default-source/hiv-hq/presentation-disru
[27]
UNAIDS. Prevailing against pandemics by putting people at the centre — World AIDS Day report 2020. 2020. Available from: https://www.unaids.org/sites/default/fles/media_asset/prevailing-against-pandemics_en.pdf
[28]
Kuehn BM. Reduced HIV testing and diagnoses during COVID-19 pandemic. JAMA 2022; 328(6): 519-9.
[http://dx.doi.org/10.1001/jama.2022.12790] [PMID: 35943465]
[29]
Garcia PJ, Cabrera DM, Cárcamo PM, Diaz MM. HIV and COVID-19 in Latin America and the Caribbean. Curr HIV/AIDS Rep 2022; 19(1): 37-45.
[http://dx.doi.org/10.1007/s11904-021-00589-4] [PMID: 35092570]
[30]
Lagat H, Sharma M, Kariithi E, et al. Impact of the COVID-19 pandemic on HIV testing and assisted partner notification services. AIDS Behav 2020; 24(11): 3010-3.
[http://dx.doi.org/10.1007/s10461-020-02938-7] [PMID: 32488552]
[31]
Person AK, Maruri F, Brazier E, et al. 475. Describing the impact of the COVID-19 pandemic on HIV care in Latin America. Open Forum Infect Dis 2020; 7(S1): S303-4.
[http://dx.doi.org/10.1093/ofid/ofaa439.668]
[32]
Santos GM, Ackerman B, Rao A, et al. Economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response on a global sample of cisgender gay men and other men who have sex with men. AIDS Behav 2021; 25(2): 311-21.
[http://dx.doi.org/10.1007/s10461-020-02969-0] [PMID: 32654021]
[33]
Centers for Disease Control and Prevention HIV Self Testing Guidance. 2020. Available from: https://www.cdc.gov/nchhstp/dear
[34]
Ejima K, Koizumi Y, Yamamoto N, Rosenberg M, Ludema C, Bento AI. HIV testing by public health centers and municipalities and new HIV cases during the COVID-19 pandemic in Japan. J Acquir Immune Defic Syndr 2021; 87(2): e182-7.
[35]
Cepal N. Latin America and the Caribbean and the COVID-19 pandemic: economic and social effects. Chile: ECLAC 2020.
[36]
Brown LB, Spinelli MA, Gandhi M. The interplay between HIV and COVID-19: summary of the data and responses to date. Curr Opin HIV AIDS 2021; 16(1): 63-73.
[http://dx.doi.org/10.1097/COH.0000000000000659] [PMID: 33186229]
[37]
Gatechompol S, Avihingsanon A, Putcharoen O, Ruxrungtham K, Kuritzkes DR. COVID-19 and HIV infection co-pandemics and their impact: A review of the literature. AIDS Res Ther 2021; 18(1): 28.
[http://dx.doi.org/10.1186/s12981-021-00335-1] [PMID: 33952300]

Rights & Permissions Print Cite
Article Metrics
18
2
© 2024 Bentham Science Publishers | Privacy Policy