Dataset Information

Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote?

ABSTRACT:

Objective

In French Guiana, the French territory with the most preoccupying HIV epidemic, there have been great efforts to intensify and diversify HIV testing strategies. The aim of the present study was to review the temporal trends of patients diagnosed with advanced HIV disease in French Guiana. Data trends from the HIV cohort of French Guiana between 1996 and 2016 were thus analyzed.

Results

The proportion of patients diagnosed with advanced disease did not decline over time. Males had lower CD4 counts at the time of diagnosis and there was a plateau for both males (around 40%) and females (around 25%) with no apparent reduction of the proportion of advanced disease. Older age groups and migrants presented more often with advanced disease. By contrast, the proportion of patients diagnosed with stage B and C disease declined over time and the CD4 count at antiretroviral initiation and the CD4 nadir increased over time. Despite some progress, the group of patients with advanced disease reached a plateau around 30% suggesting this particular group still has epidemiological importance in driving the epidemic and in fueling morbidity and mortality, and thus remains a challenge for testing strategies.

SUBMITTER: Nacher M

PROVIDER: S-EPMC6258272 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote?

Nacher Mathieu M Huber Florence F Adriouch Leila L Djossou Félix F Adenis Antoine A Couppié Pierre P

BMC research notes 20181126 1

<h4>Objective</h4>In French Guiana, the French territory with the most preoccupying HIV epidemic, there have been great efforts to intensify and diversify HIV testing strategies. The aim of the present study was to review the temporal trends of patients diagnosed with advanced HIV disease in French Guiana. Data trends from the HIV cohort of French Guiana between 1996 and 2016 were thus analyzed.<h4>Results</h4>The proportion of patients diagnosed with advanced disease did not decline over time. ...[more]

PMID: 30477588

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Project description:BackgroundGiven the great efforts put into the strategic objective of reducing the proportion of HIV-infected patients that are undiagnosed, the aim of the present study was to review the temporal trends between 1997 and 2016 for median estimates of infection duration and median CD4 count at diagnosis for the main patient origins in French Guiana.MethodsCD4 cell count at HIV sero-conversion and square root of CD4 cell decline were obtained using the CD4 decline in a cohort of HIV-infected persons in the UK, fitting random effect (slope and intercept) multilevel linear regression models. Multivariate analysis used robust regression for modeling the delay between estimated HIV seroconversion and diagnosis and quantile regression for CD4 at HIV diagnosis.ResultsThe median interval between the estimated HIV seroconversion and HIV diagnosis was 8 years for patients fromBrazil, 4.5 years for those from Haiti, 6.6 years for those from Suriname, 3.3 years for patients from Guyana, and 3.1 years for French patients. A simple robust regression model with French patients as reference group adjusting for sex and age at the time of diagnosis showed that the interval was significantly longer for Brazilian (? = +3.7 years, P = 0.001), Surinamese (? = +4.2 years, P<0.0001), Haitian origins (? = +1.5 years, P = 0.049) but not for those originating from Guyana (? = -0.03 years, P = 0.9); Men independently had a longer interval than women (? = +3.5 years, P<0.0001).ConclusionsDespite great efforts in French Guiana regarding HIV testing both in terms of diversification and intensification we still need to tailor the offer to better reach the communities in need. These results should help authorities scale up and optimize initiatives to reduce the proportion of patients who are unaware of their infection. They also raise the question of the role of stigma and discrimination as a barrier to HIV testing in small communities, and further emphasize the importance of reducing it.

Dataset Information

Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote?

Objective

Results

Publications

Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote?

Similar Datasets

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