Late Presentation - PowerPoint Presentation

Slide1

Late Presentation of HIV Infection

James Hand

Clinical Nurse Manager for HIV & Hepatitis Research

Barts

Health NHS TrustSlide2

Definitions

Late

presentation:

Persons presenting

for care with a

CD4

<

350/mm3

cells

or presenting with an AIDS-defining event, regardless of the

CD4. Slide3

Definitions

Presentation

with advanced HIV disease:

Persons presenting

for care with a CD4

<200/mm3

or

presenting with an AIDS-defining event, regardless of the

CD4.Slide4

In 2012 Half of these cases of HIV were reported as late presenters (LP) (CD4 <350/mm3)

30% of

late presenters

had advanced HIV infection (CD4 <200/mm3)

Late diagnosis in EuropeSlide5

COHERE study

Late presentation was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis.

Late presentation or very late presentation significantly increased the risk of AIDS/death in the first two years after entry into HIV

care

Mocroft

A et al.

Risk factors and outcomes for late presentation for HIV-positive persons in Europe: results from the Collaboration of Observational HIV Epidemiological Research Europe

Study

(COHERE).

PLOS Medicine: 10:9, e1001510, 2013. Slide6

Europe

Rate of late presentation are declining in MSM.

People over 50 are more likely to present late in infection.

Immigrants more likely to be late presenters.

Hofstra

M et al. Late presentation of HIV infection in Europe. 14th European AIDS Conference, Brussels, abstract LBPS8/3, 2013.   Slide7

Why do people present

late?

Stigma

Fear

Ignorance

Lack of availability of testingSlide8

How can we reduce late presentation

?

Increase HIV testing

Universal Opt out testing

Increasing HIV Knowledge

Reducing Stigma

What is feasible with limited resources?Slide9