Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021.

Autor:	Roussos S; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Pantazis N; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Protopapas K; 4th Department of Internal Medicine and HIV/ID Unit, ATTIKON University General Hospital, Athens, Greece., Antoniadou A; 4th Department of Internal Medicine and HIV/ID Unit, ATTIKON University General Hospital, Athens, Greece., Papadopoulos A; 4th Department of Internal Medicine and HIV/ID Unit, ATTIKON University General Hospital, Athens, Greece., Lourida G; 5th Department of Internal Medicine and HIV/ID Unit, Evangelismos General Hospital, Athens, Greece., Papastamopoulos V; 5th Department of Internal Medicine and HIV/ID Unit, Evangelismos General Hospital, Athens, Greece., Chini M; 3rd Department of Internal Medicine and HIV/ID Unit, 'Red Cross' Korgialeneio-Benakeio General Hospital, Athens, Greece., Alexakis K; Department of Internal Medicine and HIV/ID Unit, Herakleion University General Hospital (PAGNH), Herakleion, Crete, Greece., Barbounakis E; Department of Internal Medicine and HIV/ID Unit, Herakleion University General Hospital (PAGNH), Herakleion, Crete, Greece., Kofteridis D; Department of Internal Medicine and HIV/ID Unit, Herakleion University General Hospital (PAGNH), Herakleion, Crete, Greece., Leonidou L; Department of Medicine and HIV/ID Unit, Patras University General Hospital, Patras, Greece., Marangos M; Department of Medicine and HIV/ID Unit, Patras University General Hospital, Patras, Greece., Petrakis V; Department of Internal Medicine and HIV/ID Unit, Alexandroupolis University General Hospital, Alexandroupolis, Greece., Panagopoulos P; Department of Internal Medicine and HIV/ID Unit, Alexandroupolis University General Hospital, Alexandroupolis, Greece., Mastrogianni E; 1st Department of Internal Medicine, Laiko General Hospital, Athens, Greece., Basoulis D; 1st Department of Internal Medicine, Laiko General Hospital, Athens, Greece., Palla P; Pathophysiology Department, Laiko General Hospital, Athens, Greece., Sipsas N; Pathophysiology Department, Laiko General Hospital, Athens, Greece., Vasalou V; 1st Department of Dermatology and Venereology, HIV Unit, Andreas Syggros University Hospital, Athens, Greece., Paparizos V; 1st Department of Dermatology and Venereology, HIV Unit, Andreas Syggros University Hospital, Athens, Greece., Metallidis S; 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Thessaloniki, Greece., Chrysanthidis T; 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Thessaloniki, Greece., Katsarolis I; Medical Affairs, Gilead Sciences Hellas and Cyprus, Paleo Faliro, Greece., Sypsa V; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Psichogiou M; 1st Department of Internal Medicine, Laiko General Hospital, Athens, Greece.
Jazyk:	angličtina
Zdroj:	Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin [Euro Surveill] 2024 Nov; Vol. 29 (48).
DOI:	10.2807/1560-7917.ES.2024.29.48.2400138
Abstrakt:	BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.
Databáze:	MEDLINE
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