Estimating the Burden of HIV Late Presentation and Its Attributable Morbidity and Mortality across Europe 2010\textendash 2016 - Sorbonne Université
Journal Articles BMC Infectious Diseases Year : 2020

Estimating the Burden of HIV Late Presentation and Its Attributable Morbidity and Mortality across Europe 2010\textendash 2016

Abstract

Abstract Background Late presentation (LP), defined as a CD4 count <\,350/mm 3 or an AIDS-event at HIV-diagnosis, remains a significant problem across Europe. Linking cohort and surveillance data, we assessed the country-specific burden of LP during 2010\textendash 2016 and the occurrence of new AIDS events or deaths within 12\,months of HIV-diagnosis believed to be attributable to LP. Methods Country-specific percentages of LP and AIDS-events/death rates (assessed with Poisson regression) observed in The Collaboration of Observational HIV Epidemiological Research Europe (COHERE) and EuroSIDA cohorts, were applied to new HIV-diagnoses reported to the European Centre for Disease Prevention and Control. The estimated number of LP in the whole population was then calculated, as was the number of excess AIDS-events/deaths in the first 12\,months following HIV-diagnosis assumed to be attributable to LP (difference in estimated events between LP and non-LP). Results Thirty-nine thousand two hundred four persons were included from the COHERE and EuroSIDA cohorts, of whom 18,967 (48.4%; 95% Confidence Interval [CI] 47.9\textendash 48.9) were classified as LP, ranging from 36.9% in Estonia (95%CI 25.2\textendash 48.7) and Ukraine (95%CI 30.0\textendash 43.8) to 64.2% in Poland (95%CI 57.2\textendash 71.3). We estimated a total of >\,320,000 LP and 12,050 new AIDS-events/deaths attributable to LP during 2010\textendash 2016, with the highest estimated numbers of LP and excess AIDS-events/deaths in Eastern Europe. Country-level estimates of excess events ranged from 17 AIDS-events/deaths (95%CI 0\textendash 533) in Denmark to 10,357 (95%CI 7768-147,448) in Russia. Conclusions Across countries in Europe, the burden of LP was high, with the highest estimated number of LP and excess AIDS-events/deaths being in Eastern Europe. Effective strategies are needed to reduce LP and the attributable morbidity and mortality that could be potentially avoided.

Dates and versions

hal-03704001 , version 1 (24-06-2022)

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Lacombe Karine, In Eurosida The Late Presentation Working Groups, Cohere Cohere. Estimating the Burden of HIV Late Presentation and Its Attributable Morbidity and Mortality across Europe 2010\textendash 2016. BMC Infectious Diseases, 2020, 20 (1), pp.728. ⟨10.1186/s12879-020-05261-7⟩. ⟨hal-03704001⟩
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