Late diagnosis in the HAART era: proposed common definitions and associations with mortality

• DOI: 10.1097/qad.0b013e328333fa0f
• Publication Date: 2021-01-31T04:24:49Z
• Authors: Caroline Sabin; Achim Schwenk; Margaret Johnson; Brian Gazzard; Martin Fisher; John Walsh; Chloe Orkin; Teresa Hill; Richard Gilson; Kholoud Porter; Philippa Easterbrook; Valérie Delpech; Clifford Leen; Clifford Leen; Mark Gompels; Jane Anderson; Andrew Phillips
• Keywords: Adult; Male; Delayed Diagnosis; Antiretroviral Therapy; 610; HIV Infections; Prognosis; CD4 Lymphocyte Count; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Antiretroviral Therapy, Highly Active; Disease Progression; HIV-1; Humans; Highly Active; Female

Objective: To identify a definition of presentation after clinical or immunological disease progression that will reliably an individual at high risk mortality over the first 3 months HIV diagnosis and can be adopted as basis for comparing time regions. Design: An observational cohort study. Methods: Individuals seen UK Collaborative Cohort study clinic from 1996 to 2006 were identified. Two (CD4 cell count < 200 cells/μl CD4 <50 cells/μl) two (AIDS severe/moderate AIDS) criteria with advanced compared, well combinations them. The predictive ability each identifying individuals who died in was assessed. Results: Fifteen thousand seven hundred seventy-four patients included, whom 1495 (9.5%), 4231 (26.8%), 1523 (9.7%) 379 (2.4%) had below 50 cells/μl, AIDS diagnosis; counts unavailable 2264 (14.4%) patients. six (1.3%) within months. Sensitivities ranged 18.0% (severe/moderate 50.5% specificities ranging 73.5% 97.8% AIDS). Combinations increased sensitivity but decreased specificity. Conclusion: We propose ‘advanced disease’ is AIDS, whereas ‘late’ defined when treatment should initiated (currently 350