Many with HIV start care too late

May 28, 2010

Despite growing evidence that the earlier people are diagnosed with HIV and get access to care, the better their clinical outcomes, many HIV-infected people in the United States and Canada are not receiving the care they need early enough. A study of nearly 45,000 patients in both countries highlighting this trend appears in the June 1, 2010, issue of Clinical Infectious Diseases, now available online (http://www.journals.uchicago.edu/doi/abs/10.1086/652650).

Researchers analyzed patients' CD4 cell counts, a critical measure of immune system strength, when these patients first began clinical care for HIV from 1997 to 2007. Although the median CD4 count at first presentation increased annually over this period, from 256 cells/mm3 to 317 cells/mm3, it remains below the level currently recommended for patients to start antiretroviral therapy, 350 cells/mm3. The median age at which patients first received HIV care increased over the study period from 40 to 43 years of age.

"The public health implications of our findings are clear: Delayed diagnosis reduces survival, and individuals enter into HIV care with lower CD4 counts than the guidelines for antiretroviral therapy initiation," said study author Richard Moore, MD, of Johns Hopkins University School of Medicine in Baltimore. "A delay in presentation for treatment not only increases the chance of clinical disease progression but also increases the risk of ongoing transmission."

In an accompanying editorial, Cynthia Gay, MD, of the University of North Carolina at Chapel Hill, agreed: "These findings reveal that despite such compelling data, there is much room for improving our ability to link more HIV-infected individuals with effective treatment prior to immunological deterioration."
-end-
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing more than 9,000 physicians and scientists who specialize in infectious diseases. The HIV Medicine Association (HIVMA), nested within IDSA, is the professional home for more than 3,800 physicians, scientists, and other health care professionals dedicated to the field of HIV/AIDS. For more information, visit our websites: www.idsociety.org and www.hivma.org.

Infectious Diseases Society of America

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.