Late presentation into care of HIV disease and its associated factors in Asia: Results of TAHOD

Su Jin Jeong, Claire Italiano, Romanee Chaiwarith, Oon Tek Ng, Sasheela Vanar, Awachana Jiamsakul, Vonthanak Saphonn, Kinh Van Nguyen, Sasisopin Kiertiburanakul, Man Po Lee, Tuti Parwati Merati, Thuy Thanh Pham, Evy Yunihastuti, Rossana Ditangco, Nagalingeswaran Kumarasamy, Fujie Zhang, Wingwai Wong, Benedict L.H. Sim, Sanjay Pujari, Pacharee KantipongPraphan Phanuphak, Winai Ratanasuwan, Shinichi Oka, Mahiran Mustafa, Nicolas Durier, JunYong Choi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Many HIV-infected individuals do not enter health care until late in the infection course. Despite encouraging earlier testing, this situation has continued for several years. We investigated the prevalence of late presenters and factors associated with late presentation among HIV-infected patients in an Asian regional cohort. This cohort study included HIV-infected patients with their first positive HIV test during 2003-2012 and CD4 count and clinical status data within 3 months of that test. Factors associated with late presentation into care (CD4 count <200 cells/μl or an AIDS-defining event within ±3 months of first positive HIV test) were analyzed in a random effects logistic regression model. Among 3,744 patients, 2,681 (72%) were late presenters. In the multivariable model, older patients were more likely to be late presenters than younger (≤30 years) patients [31-40, 41-50, and ≥51 years: odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.31-1.88; OR = 2.01, 95% CI 1.58-2.56; and OR = 1.69, 95% CI 1.23-2.31, respectively; all p ≤ 0.001]. Injecting drug users (IDU) were more likely (OR = 2.15, 95% CI 1.42-3.27, p < 0.001) and those with homosexual HIV exposure were less likely (OR = 0.45, 95% CI 0.35-0.58, p < 0.001) to be late presenters compared to those with heterosexual HIV exposure. Females were less likely to be late presenters (OR = 0.44, 95% CI 0.36-0.53, p < 0.001). The year of first positive HIV test was not associated with late presentation. Efforts to reduce the patients who first seek HIV care at the late stage are needed. The identified risk factors associated with late presentation should be utilized in formulating targeted public health intervention to improve earlier entry into HIV care.

Original languageEnglish
Pages (from-to)255-261
Number of pages7
JournalAIDS Research and Human Retroviruses
Volume32
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

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HIV
Odds Ratio
Confidence Intervals
CD4 Lymphocyte Count
Logistic Models
Heterosexuality
Drug Users
Acquired Immunodeficiency Syndrome
Cohort Studies
Public Health
Delivery of Health Care
Infection

All Science Journal Classification (ASJC) codes

  • Immunology
  • Virology
  • Infectious Diseases

Cite this

Jeong, Su Jin ; Italiano, Claire ; Chaiwarith, Romanee ; Ng, Oon Tek ; Vanar, Sasheela ; Jiamsakul, Awachana ; Saphonn, Vonthanak ; Nguyen, Kinh Van ; Kiertiburanakul, Sasisopin ; Lee, Man Po ; Merati, Tuti Parwati ; Pham, Thuy Thanh ; Yunihastuti, Evy ; Ditangco, Rossana ; Kumarasamy, Nagalingeswaran ; Zhang, Fujie ; Wong, Wingwai ; Sim, Benedict L.H. ; Pujari, Sanjay ; Kantipong, Pacharee ; Phanuphak, Praphan ; Ratanasuwan, Winai ; Oka, Shinichi ; Mustafa, Mahiran ; Durier, Nicolas ; Choi, JunYong. / Late presentation into care of HIV disease and its associated factors in Asia : Results of TAHOD. In: AIDS Research and Human Retroviruses. 2016 ; Vol. 32, No. 3. pp. 255-261.
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Jeong, SJ, Italiano, C, Chaiwarith, R, Ng, OT, Vanar, S, Jiamsakul, A, Saphonn, V, Nguyen, KV, Kiertiburanakul, S, Lee, MP, Merati, TP, Pham, TT, Yunihastuti, E, Ditangco, R, Kumarasamy, N, Zhang, F, Wong, W, Sim, BLH, Pujari, S, Kantipong, P, Phanuphak, P, Ratanasuwan, W, Oka, S, Mustafa, M, Durier, N & Choi, J 2016, 'Late presentation into care of HIV disease and its associated factors in Asia: Results of TAHOD', AIDS Research and Human Retroviruses, vol. 32, no. 3, pp. 255-261. https://doi.org/10.1089/aid.2015.0058

Late presentation into care of HIV disease and its associated factors in Asia : Results of TAHOD. / Jeong, Su Jin; Italiano, Claire; Chaiwarith, Romanee; Ng, Oon Tek; Vanar, Sasheela; Jiamsakul, Awachana; Saphonn, Vonthanak; Nguyen, Kinh Van; Kiertiburanakul, Sasisopin; Lee, Man Po; Merati, Tuti Parwati; Pham, Thuy Thanh; Yunihastuti, Evy; Ditangco, Rossana; Kumarasamy, Nagalingeswaran; Zhang, Fujie; Wong, Wingwai; Sim, Benedict L.H.; Pujari, Sanjay; Kantipong, Pacharee; Phanuphak, Praphan; Ratanasuwan, Winai; Oka, Shinichi; Mustafa, Mahiran; Durier, Nicolas; Choi, JunYong.

In: AIDS Research and Human Retroviruses, Vol. 32, No. 3, 01.03.2016, p. 255-261.

Research output: Contribution to journalArticle

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T1 - Late presentation into care of HIV disease and its associated factors in Asia

T2 - Results of TAHOD

AU - Jeong, Su Jin

AU - Italiano, Claire

AU - Chaiwarith, Romanee

AU - Ng, Oon Tek

AU - Vanar, Sasheela

AU - Jiamsakul, Awachana

AU - Saphonn, Vonthanak

AU - Nguyen, Kinh Van

AU - Kiertiburanakul, Sasisopin

AU - Lee, Man Po

AU - Merati, Tuti Parwati

AU - Pham, Thuy Thanh

AU - Yunihastuti, Evy

AU - Ditangco, Rossana

AU - Kumarasamy, Nagalingeswaran

AU - Zhang, Fujie

AU - Wong, Wingwai

AU - Sim, Benedict L.H.

AU - Pujari, Sanjay

AU - Kantipong, Pacharee

AU - Phanuphak, Praphan

AU - Ratanasuwan, Winai

AU - Oka, Shinichi

AU - Mustafa, Mahiran

AU - Durier, Nicolas

AU - Choi, JunYong

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Many HIV-infected individuals do not enter health care until late in the infection course. Despite encouraging earlier testing, this situation has continued for several years. We investigated the prevalence of late presenters and factors associated with late presentation among HIV-infected patients in an Asian regional cohort. This cohort study included HIV-infected patients with their first positive HIV test during 2003-2012 and CD4 count and clinical status data within 3 months of that test. Factors associated with late presentation into care (CD4 count <200 cells/μl or an AIDS-defining event within ±3 months of first positive HIV test) were analyzed in a random effects logistic regression model. Among 3,744 patients, 2,681 (72%) were late presenters. In the multivariable model, older patients were more likely to be late presenters than younger (≤30 years) patients [31-40, 41-50, and ≥51 years: odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.31-1.88; OR = 2.01, 95% CI 1.58-2.56; and OR = 1.69, 95% CI 1.23-2.31, respectively; all p ≤ 0.001]. Injecting drug users (IDU) were more likely (OR = 2.15, 95% CI 1.42-3.27, p < 0.001) and those with homosexual HIV exposure were less likely (OR = 0.45, 95% CI 0.35-0.58, p < 0.001) to be late presenters compared to those with heterosexual HIV exposure. Females were less likely to be late presenters (OR = 0.44, 95% CI 0.36-0.53, p < 0.001). The year of first positive HIV test was not associated with late presentation. Efforts to reduce the patients who first seek HIV care at the late stage are needed. The identified risk factors associated with late presentation should be utilized in formulating targeted public health intervention to improve earlier entry into HIV care.

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