Generic placeholder image

Current HIV Research

Editor-in-Chief

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

Research Article

Epidemiological and Clinical Profile of Newly Diagnosed HIV/AIDS Patients: A Retrospective Analysis of Changing Trends Over 16 Years

Author(s): Esra Zerdali*, Inci Yilmaz Nakir, Uğurcan Sayili, Serkan Sürme and Mustafa Yildırım

Volume 21, Issue 1, 2023

Published on: 31 January, 2023

Page: [35 - 42] Pages: 8

DOI: 10.2174/1570162X21666230111150431

Price: $65

Abstract

Objective: To evaluate the epidemiological profile and clinical findings of newly diagnosed HIV-infected patients in terms of changing trends over 16 years.

Methods: A total of 748 patients (mean ± SD age: 34 ± 11.6 years, 88.9% were males) newly diagnosed with HIV/AIDS at a tertiary care hospital located in Istanbul province between 2002 and 2017 were included in this retrospective study. Data on sociodemographic characteristics, potential routes of transmission, the reason for HIV testing, time from diagnosis to treatment onset, and the HIV RNA values and CD4+ T cell count (at diagnosis and treatment onset) were recorded in each patient and compared between the diagnoses made within the 2002-2009 (n = 141) vs. 2010-2017 (n = 607) periods.

Results: When compared to HIV diagnoses within the 2002-2009 period, the diagnoses made within the 2010-2017 period were associated with a significantly higher percentage of males (78.7 vs. 91.3%, p < 0.001), 18-29 years age group (23.6% vs. 35.5%, p = 0.029), singles (34.0 vs. 49.6%, p = 0.004), university graduates (9.9 vs. 23.4%, p < 0.001) and students (0.7 vs. 8.2%, p < 0.001) along with an increased likelihood of voluntary testing (6.4 vs. 15.2%, p = 0.048) and a lower percentage of heterosexual individuals (63.8 vs. 47.0%, p < 0.001). Sexual contact (88.0%) was the leading transmission route, and the presence of complaints (44.3%) was the leading reason for HIV testing. Overall, the time from diagnosis to treatment onset was a median 1 month (range, 1 to 97 months), and the median HIV RNA level at the time of diagnosis was 208065 copies/mL with no significant difference between study periods. The diagnoses within the 2010-2017 vs. 2002-2009 period were associated with significantly higher median (min-max) CD4+ T cell counts (378(0-2522) vs. 319(4-1270) cells/mm3, p < 0.001) and a lower percentage of patients with CD4+ T cell count < 200 cells/mm3 (22.1 vs. 39.0%, p = 0.002) at the time of diagnosis.

Conclusion: In conclusion, our findings on the epidemiological profile and clinical characteristics of newly diagnosed HIV patients over 16 years (2002-2017) in a tertiary care center in Turkey revealed a considerable increase in the number of new diagnoses, an improved earlier diagnosis and a change in epidemiologic profile over the years with increased likelihood of disease to be more commonly diagnosed among males, 18-29 years age group and MSM.

Graphical Abstract

[1]
UN Joint Programme on HIV/AIDS, Global Report: UNAIDS Report on the Global AIDS Epidemic: 2012.
[2]
Joint United Nations Programme on HIV/AIDS.. Global AIDS update 2019. 2019. Available from: https://www.unaids.org/sites/default/ files/media_asset/2019-UNAIDS-data_en.pdf
[4]
Gökengin D, Oprea C, Uysal S, Begovac J. The growing HIV epidemic in Central Europe: A neglected issue? J Virus Erad 2016; 2(3): 156-61.
[http://dx.doi.org/10.1016/S2055-6640(20)30459-3] [PMID: 27482455]
[5]
European Centre for Disease Prevention and Control/WHO RegionalOffice for Europe. HIV/AIDS surveillance in Europe 2019-2018 data. Stockholm. Available from: https://www.ecdc.europa.eu/en/ publications-data/hivaids-surveillance-europe-2019-2018-data
[6]
Republic of Turkey MoH, General Directorate of Public Health, HIV/AIDS Statistics report 2019. 2019. Available from: https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hiv-aidsliste/ h%C4%B1v-aids-istatislik.html
[7]
Yemisen M, Aydın O, Gunduz A, et al. Epidemiological profile of naive HIV-1/AIDS patients in Istanbul: The largest case series from Turkey. Curr HIV Res 2014; 12(1): 60-4.
[http://dx.doi.org/10.2174/1570162X12666140411111803] [PMID: 24725060]
[8]
Çerçi̇ P, İnkaya AÇ, Alp Ş, Tümer A, Ünal S. Evaluation of 255 HIV/AIDS cases: Hacettepe cohort, Ankara, Turkey. Mikrobiyol Bul 2016; 50(1): 94-103.
[http://dx.doi.org/10.5578/mb.10610] [PMID: 27058333]
[9]
Ertunc B, Kaya S, Koksal I. Clinico-epidemiological analysis of HIV/AIDS patients. Eurasian J Med 2017; 48(3): 157-61.
[http://dx.doi.org/10.5152/eurasianjmed.2016.15203] [PMID: 28149137]
[10]
Erdinc FS, Dokuzoguz B, Unal S, et al. Temporal trends in the epidemiology of HIV in Turkey. Curr HIV Res 2020; 18(4): 258-66.
[http://dx.doi.org/10.2174/1570162X18666200427223823] [PMID: 32342820]
[11]
Frank TD, Carter A, Jahagirdar D, et al. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Lancet HIV 2019; 6(12): e831-59.
[http://dx.doi.org/10.1016/S2352-3018(19)30196-1] [PMID: 31439534]
[12]
Trickey A, May MT, Vehreschild JJ, et al. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: A collaborative analysis of cohort studies. Lancet HIV 2017; 4(8): e349-56.
[http://dx.doi.org/10.1016/S2352-3018(17)30066-8] [PMID: 28501495]
[13]
Montana JF, Ferreira GRON, Cunha CLF, et al. The HIV epidemic in Colombia: Spatial and temporal trends analysis. BMC Public Health 2021; 21(1): 178.
[http://dx.doi.org/10.1186/s12889-021-10196-y] [PMID: 33478434]
[14]
Stafford KA, Nganga LW, Tulli T, Foreit KGF. Factors associated with outcomes of pre-ART HIV care. J Int Assoc Provid AIDS Care 2018; 17: 2325958218759602.
[http://dx.doi.org/10.1177/2325958218759602] [PMID: 29534654]
[15]
Wekesa P, McLigeyo A, Owuor K, Mwangi J, Isavwa L, Katana A. Temporal trends in pre-ART patient characteristics and outcomes before the test and treat era in Central Kenya. BMC Infect Dis 2021; 21(1): 1007.
[http://dx.doi.org/10.1186/s12879-021-06706-3] [PMID: 34565337]
[16]
Celikbas A, Ergonul O, Baykam N, et al. Epidemiologic and clinical characteristics of HIV/AIDS patients in Turkey, where the prevalence is the lowest in the region. J Int Assoc Physicians AIDS Care (Chic) 2008; 7(1): 42-5.
[http://dx.doi.org/10.1177/1545109707306575] [PMID: 17989428]
[17]
Dokuzoguz B, Korten V, Gökengin D, et al. Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012. J Int AIDS Soc 2014; 17(4): 19595.
[http://dx.doi.org/10.7448/IAS.17.4.19595] [PMID: 25394100]
[18]
Ferrer L, Loureiro E, Meulbroek M, et al. High HIV incidence among men who have sex with men attending a community-based voluntary counselling and testing service in Barcelona, Spain: Results from the ITACA cohort. Sex Transm Infect 2016; 92(1): 70-5.
[http://dx.doi.org/10.1136/sextrans-2015-052042] [PMID: 26136507]
[19]
Assi A, Abu Zaki S, Ghosn J, et al. Prevalence of HIV and other sexually transmitted infections and their association with sexual practices and substance use among 2238 MSM in Lebanon. Sci Rep 2019; 9(1): 15142.
[http://dx.doi.org/10.1038/s41598-019-51688-7] [PMID: 31641252]
[20]
Beyrer C, Sullivan P, Sanchez J, et al. The increase in global HIV epidemics in MSM. AIDS 2013; 27(17): 2665-78.
[http://dx.doi.org/10.1097/01.aids.0000432449.30239.fe] [PMID: 23842129]
[21]
Yin Y, Liu Y, Zhu J, et al. The prevalence, temporal trends, and geographical distribution of HIV-1 subtypes among men who have sex with men in China: A systematic review and meta-analysis. Epidemiol Infect 2019; 147: e83.
[http://dx.doi.org/10.1017/S0950268818003400] [PMID: 30869019]
[22]
Leelawiwat W, Rutvisuttinunt W, Arroyo M, et al. Increasing HIV-1 molecular complexity among men who have sex with men in Bangkok. AIDS Res Hum Retroviruses 2015; 31(4): 393-400.
[http://dx.doi.org/10.1089/aid.2014.0139] [PMID: 25366819]
[23]
al Chen Y. Limited introductions and genetic variation of HIV-1 in a MSM cohort in China. AIDS Res Hum Retroviruses 2010; 26: A144-4.
[24]
Yan J, Xin R, Li Z, et al. CRF01_AE/B/C, a novel drug-resistant HIV-1 recombinant in men who have sex with men in Beijing, China. AIDS Res Hum Retroviruses 2015; 31(7): 745-8.
[http://dx.doi.org/10.1089/aid.2015.0064] [PMID: 25962473]
[25]
Zhang L, Wang Y, Wang B, Yan J, Wan Y, Wang J. Prevalence of HIV-1 subtypes among men who have sex with men in China: A systematic review. Int J STD AIDS 2015; 26(5): 291-305.
[http://dx.doi.org/10.1177/0956462414543841] [PMID: 25033880]
[26]
Haddad N, Robert A, Weeks A, Popovic N, Siu W, Archibald C. HIV in Canada-Surveillance Report, 2018. Can Commun Dis Rep 2019; 45(12): 304-12.
[http://dx.doi.org/10.14745/ccdr.v45i12a01] [PMID: 32167090]
[27]
Djellouli N, Quevedo-Gómez MC. Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia. Soc Sci Med 2015; 133: 36-44.
[http://dx.doi.org/10.1016/j.socscimed.2015.03.048] [PMID: 25840048]
[28]
Hatam.. 2012 HIV Data of Turkey. 2012. Available from: http://www.hatam.hacettepe.edu.tr/verilerAralik2012.pdf
[29]
Karaosmanoglu HK, Aydin OA, Nazlican O. Profile of HIV/AIDS patients in a tertiary hospital in Istanbul, Turkey. HIV Clin Trials 2011; 12(2): 104-8.
[http://dx.doi.org/10.1310/hct1202-104] [PMID: 21498153]
[30]
Rio CD, Curan JW. Epidemiology and prevention of Acquired Immunodefi ciency Syndrome and Human Virus Infection. In: Mandell GL, Bennett JE, Dolin R, Eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectıous Diseases. 7th ed.; Philadelphia, PA: Churchill Livingstone Elsevier 2010; Vol. 1: pp. 1635-61.
[31]
Ramchandani SR, Mehta SH, Saple DG, et al. Knowledge, attitudes, and practices of antiretroviral therapy among HIV-infected adults attending private and public clinics in India. AIDS Patient Care STDS 2007; 21(2): 129-42.
[http://dx.doi.org/10.1089/apc.2006.0045] [PMID: 17328662]
[32]
Smith Fawzi MC, Jagannathan P, Cabral J, et al. Limitations in knowledge of HIV transmission among HIV-positive patients accessing case management services in a resource-poor setting. AIDS Care 2006; 18(7): 764-71.
[http://dx.doi.org/10.1080/09540120500373844] [PMID: 16971286]
[33]
Kose S, Mandiracioglu A, Mermut G, Kaptan F, Ozbel Y. The social and health problems of people living with HIV/AIDS in Izmir, Turkey. Eurasian J Med 2012; 44(1): 32-9.
[http://dx.doi.org/10.5152/eajm.2012.07] [PMID: 25610202]
[34]
Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: A mathematical model. Lancet 2009; 373(9657): 48-57.
[http://dx.doi.org/10.1016/S0140-6736(08)61697-9] [PMID: 19038438]
[35]
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. 2nd ed.; Geneva: World Health Organization 2016.
[36]
Herce ME, Chi BH, Liao RC, Hoffmann CJ. Re-thinking linkage to care in the era of universal test and treat: Insights from implementation and behavioral science for achieving the second 90. AIDS Behav 2019; 23(S2): 120-8.
[http://dx.doi.org/10.1007/s10461-019-02541-5] [PMID: 31161462]
[37]
García Deltoro M. Rapid initiation of antiretroviral therapy after HIV diagnosis. AIDS Rev 2019; 21(2): 55-64.
[http://dx.doi.org/10.24875/AIDSRev.M19000027] [PMID: 31332395]
[38]
Boyd MA, Boffito M, Castagna A, Estrada V. Rapid initiation of antiretroviral therapy at HIV diagnosis: Definition, process, knowledge gaps. HIV Med 2019; 20(S1): 3-11.
[http://dx.doi.org/10.1111/hiv.12708] [PMID: 30724450]
[39]
Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016; 316(2): 171-81.
[http://dx.doi.org/10.1001/jama.2016.5148] [PMID: 27404185]
[40]
Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): Final results of a multicentre, prospective, observational study. Lancet 2019; 393(10189): 2428-38.
[http://dx.doi.org/10.1016/S0140-6736(19)30418-0] [PMID: 31056293]
[41]
Korten V, Gökengin D, Fincanci M, et al. Outcomes of initial antiretroviral treatment (ART) among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012. J Int AIDS Soc 2014; 17(4): 19678.
[http://dx.doi.org/10.7448/IAS.17.4.19678] [PMID: 25397428]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy