Associations of HIV testing and late diagnosis at a Japanese university hospital

Authors

  • Tetsuya Horino Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Fumiya Sato Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Tetsuro Kato Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Yumiko Hosaka Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Akihiro Shimizu Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Shinji Kawano Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Tokio Hoshina Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Kazuhiko Nakaharai Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Yasushi Nakazawa Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Koji Yoshikawa Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Masaki Yoshida Jikei University School of Medicine; Department of Infectious Diseases and Infection Control
  • Seiji Hori Jikei University School of Medicine; Department of Infectious Diseases and Infection Control

DOI:

https://doi.org/10.6061/clinics/2016(02)04

Abstract

OBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed. RESULTS: A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell count <350/mm3) and very late (CD4 cell count <200/mm3) diagnoses were observed in 61.4% (282/459) and 36.6% (168/459) of patients, respectively. The most common reason for HIV diagnosis was voluntary testing (38.6%, 177/459 patients), followed by AIDS-defining illness (18.3%, 84/459 patients). Multivariate analysis revealed a significant association of voluntary HIV testing with non-late and non-very-late diagnoses and there was a high proportion of AIDS-defining illness in the late and very late diagnosis groups compared with other groups. Men who have sex with men was a relative factor for non-late diagnosis, whereas nonspecific abnormal blood test results, such as hypergammaglobulinemia and thrombocytopenia, were risk factors for very late diagnosis. CONCLUSIONS: Voluntary HIV testing should be encouraged and physicians should screen all patients who have symptoms or signs and particularly hypergammaglobulinemia and thrombocytopenia, that may nonspecifically indicate HIV infection.

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Published

2016-02-01

Issue

Section

Clinical Sciences

How to Cite

Horino, T., Sato, F., Kato, T., Hosaka, Y., Shimizu, A., Kawano, S., Hoshina, T., Nakaharai, K., Nakazawa, Y., Yoshikawa, K., Yoshida, M., & Hori, S. (2016). Associations of HIV testing and late diagnosis at a Japanese university hospital . Clinics, 71(2), 73-77. https://doi.org/10.6061/clinics/2016(02)04