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Current HIV Research

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

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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.

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Graphical Abstract

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