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Giménez-Arufe V, Rotea-Salvo S, Martínez-Pradeda A, Mena-de-Cea Á, Margusino-Framiñán L, Suanzes-Hernández J, Martín Herranz MI, Cid-Silva P. Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities. Healthcare (Basel) 2024; 12:361. [PMID: 38338246 PMCID: PMC10855914 DOI: 10.3390/healthcare12030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/13/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Early diagnosis of a Human Immunodeficiency Virus (HIV)-infected person represents a cornerstone of HIV prevention, treatment, and care. Numerous publications have developed recommendations where HIV serology is indicated to reduce missed diagnostic opportunities (MDOs). This retrospective study analyses new HIV infection diagnoses and the relationship between late diagnosis (LD)/advanced HIV disease (AHD), baseline characteristics, and MDOs. Sociodemographic data and data related to contact with the health system in the 5 years before diagnosis were collected. Most of the 273 diagnoses were made in primary care (48.5%). Approximately 50.5% and 34.4% had LD and AHD criteria, respectively. Female sex was associated with a higher incidence of LD. Persons infected through the heterosexual route and those at an older age had a higher risk for LD and AHD. People with previous HIV serology presented a lower percentage of LD and AHD. In total, 10% of the health contact instances were classified as MDOs, mostly occurring in primary care. A significant increase in the median of MDOs was observed in patients with LD/AHD. Female sex and hepatitis C virus co-infection were associated with an increase in the number of MDOs. The high percentage of LD and AHD and the significant number of MDOs show that the current screening system should be improved.
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Affiliation(s)
- Víctor Giménez-Arufe
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Sandra Rotea-Salvo
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Alejandro Martínez-Pradeda
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Álvaro Mena-de-Cea
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
- Service of Infectious Internal Medicine, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain
| | - Luis Margusino-Framiñán
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
| | - Jorge Suanzes-Hernández
- Clinical Epidemiology and Biostatistics Unit, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
| | - María Isabel Martín Herranz
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Purificación Cid-Silva
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
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