2026-08-25T16:15:01Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/102802025-06-24T09:05:16Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608
Repisalud
author
Moreno, Santiago
author
Rubio, Rafael
author
Viciana, Pompeyo
author
Bernardino, Jose Ignacio
author
Blanco, José Ramón
author
Bernal, Enrique
author
Asensi, Víctor
author
Pulido, Federico
author
Amo, Julia del
author
Hernando Sebastian, Victoria
author
Sobrino-Vegas, Paz
funder
Instituto de Salud Carlos III
funder
Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
2020-06-05T07:15:15Z
2020-06-05T07:15:15Z
2016-05
J Infect . 2016 May;72(5):587-96.
10.1016/j.jinf.2016.01.017
1532-2742
The Journal of infection
26920789
http://hdl.handle.net/20.500.12105/10280
Objectives: To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Methods: Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS. Results: Of 7165 new HIV diagnoses, 46.9% (CI95%:45.7-48.0) were LP, 240 patients died. First-year mortality was the highest (aHRLP.vs.nLP = 10.3[CI95%:5.5-19.3]); between 1 and 4 years post-diagnosis, aHRLP.vs.nLP = 1.9(1.2-3.0); and >4 years, aHRLP.vs.nLP = 1.5(0.7-3.1). First-year's main cause of death was HIV/AIDS (73%); and malignancies among those surviving >4 years (32%). HIV/AIDS-related deaths were more likely in LP (59.2% vs. 25.0%; p < 0.001). LP declined from 55.9% (2004-05) to 39.4% (2012-13), and reduced in 46.1% in men who have sex with men (MSM) and 37.6% in heterosexual men, but increased in 22.6% in heterosexual women. Factors associated with LP: sex (ORMEN.vs.WOMEN = 1.4[1.2-1.7]); age (OR31-40.vs.<30 = 1.6[1.4-1.8], OR41-50.vs.<30 = 2.2[1.8-2.6], OR>50.vs.<30 = 3.6[2.9-4.4]); behavior (ORInjectedDrugUse.vs.MSM = 2.8[2.0-3.8]; ORHeterosexual.vs.MSM = 2.2[1.7-3.0]); education (ORPrimaryEducation.vs.University = 1.5[1.1-2.0], ORLowerSecondary.vs.University = 1.3[1.1-1.5]); and geographical origin (ORSub-Saharan.vs.Spain = 1.6[1.3-2.0], ORLatin-American.vs.Spain = 1.4[1.2-1.8]). Conclusions: LP is associated with higher mortality, especially short-term- and HIV/AIDS-related mortality. Mid-term-, but not long-term mortality, remained also higher in LP than nLP. LP decreased in MSM and heterosexual men, not in heterosexual women. The groups most affected by LP are low educated, non-Spanish and heterosexual women.
eng
Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort: 2004-2013
research article
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URL
https://repisalud.isciii.es/bitstreams/054b87b2-67b8-4124-9c44-751f452c1592/download
File
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application/pdf
ImpactOfLatePresentation_2016.pdf
URL
https://repisalud.isciii.es/bitstreams/f741b879-5e47-403a-b80d-68c8cbda1517/download
File
MD5
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text/plain
ImpactOfLatePresentation_2016.pdf.txt