1. Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996-2014: results from a national observational cohort
- Author
-
Op De Coul, Eline L.M., Van Sighem, Ard, Brinkman, Kees, Van Benthem, Birgit H., Van Der Ende, Marchina E., Geerlings, Suzanne, Reiss, Peter, Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., Van Der Meer, J. T.M., Wit, F.W.N.M., Godfried, M. H., Reiss, P., Van Der Poll, T., Nellen, F. J.B., Geerlings, S. E., Van Vugt, M., Pajkrt, D., Bos, J. C., Wiersinga, W. J., Van Der Valk, M., Goorhuis, A., Hovius, J. W., Van Eden, J., Henderiks, A., Van Hes, A. M.H., Mutschelknauss, M., Nobel, H. E., Pijnappel, F. J.J., Westerman, A. M., Jurriaans, S., Back, N. K.T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T.E., Schinkel, C. J., Thomas, X. V., De Ruyter Ziekenhuis, Admiraal, Van Den Berge, M., Stegeman, A., Baas, S., De Looff, L. Hage, Versteeg, D., Pronk, M. J.H., Ammerlaan, H. S.M., Korsten-Vorstermans, E. M.H.M., De Munnik, E. S., Tjhie, J., Wegdam, M. C.A., Weijsenfeld, A. M., Van Der Ende, M. E., De Vries-Sluijs, T. E.M.S., Van Gorp, E. C.M., Schurink, C. A.M., Nouwen, J. L., Verbon, A., Rijnders, B. J.A., Bax, H. I., Hassing, R. J., Van Der Feltz, M., Bassant, N., Van Beek, J. E.A., Vriesde, M., Van Zonneveld, L. M., De Oude-Lubbers, A., Van Den Berg-Cameron, H. J., Bruinsma-Broekman, F. B., De Groot, J., De Zeeuw-De Man, M., Broekhoven-Kruijne, M. J., Schutten, M., Osterhaus, A. D.M.E., Boucher, C. A.B., Driessen, G. J.A., Van Rossum, A. M.C., Van Der Knaap, L. C., Visser, E., Branger, J., Duijf-Van De Ven, C. J.H.M., Schippers, E. F., Van Nieuwkoop, C., Brimicombe, R. W., VanJperen, J. M., Van Der Hut, G., Franck, P. F.H., Van Eeden, A., Groot, M., Kwa, I. S., Bouwhuis, J. W., Van Hulzen, A. G.W., Bor, P. C.J., Bloembergen, P., Wolfhagen, M. J.H.M., Ruijs, G. J.H.M., Soetekouw, R., Van Der Prijt, L. M.M., Schoemaker, M., Van Der Reijden, W. A., Jansen, R., Herpers, B. L., Kroon, F. P., Arend, S. M., De Boer, M. G.J., Bauer, M. P., Jolink, H., Vollaard, A. M., Moons, C., Kroes, A. C.M., Pogany, K., Smit, J. V., Smit, E., Van Niekerk, T., Pontesilli, O., Lashof, A. Oude, Posthouwer, D., Schippers, J., Vergoossen, R., Loo, I. H., El Moussaoui, R., Van Twillert, G., Stuart, J. W.T.Cohen, Diederen, B. M.W., Van Truijen-Oud, F. A., Gelinck, L. B.S., Meerkerk, C., Wildenbeest, G. S., Jansen, C. L., Van Houte, D. P.F., Faber, S., Delsing, C. E., Heins, H., Frissen, P. H.J., Blok, W. L., Schouten, W. E.M., Van Den Berk, G. E.L., Brouwer, C. J., Geerders, G. F., Hoeksema, K., Kleene, M. J., Van Der Meché, I. B., Toonen, A. J.M., Wijnands, S., Keuter, M., Van Der Ven, A. J.A.M., Hofstede, Hjm Ter, Dofferhoff, A. S.M., Van Crevel, R., Bosch, M. E.W., Grintjes-Huisman, K. J.T., Zomer, B. J., Van Der Berg, J. P., Gisolf, E. H., Van Bentum, P. H.M., Langebeek, N., Swanink, C. M.A., Lettinga, K. D., Sulman, H., Witte, E., Vrouenraets, S. M.E., Lauw, F. N., Paap, H., Vlasblom, D. J., Rosingh, A. W., Brouwer, A. E., Kuipers, M., Santegoets, R. M.W.J., Van Der Ven, B., Buiting, A. G.M., Kabel, P. J., Sprenger, H. G., Scholvinck, E. H., Van Assen, S., Wilting, K. R., Stienstra, Y., Van Der Meulen, P. A., De Weerd, D. A., Riezebos-Brilman, A., Van Leer-Buter, C. C., Schneider, M. M.E., Mudrikova, T., Ellerbroek, P. M., Oosterheert, J. J., Arends, J. E., Barth, R. E., Wassenberg, M. W.M., Laan, L. M., Van Oers-Hazelzet, E. E.B., Patist, J., Vervoort, S., Frauenfelder, R., Verduyn-Lunel, F., Wensing, A. M.J., Van Agtmael, M. A., Perenboom, R. M., Bomers, M., De Vocht, J., Vandenbroucke-Grauls, C. M.J.E., Ang, C. W., Wolfs, T. F.W., Bont, L. J., Gras, L., Van Sighem, A. I., Smit, C., Hillebregt, M., Kimmel, V., Tong, Y., Van Den Boogaard, R., Hoekstra, P., De Lang, A., Berkhout, M., Grivell, S., Jansen, A., Van Den Akker, M., Bergsma, D., Lodewijk, C., Meijering, R., Peeck, B., Raethke, M., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M., Tuijn, E., Veenenberg, L., Woudstra, T., Bakker, Y., De Jong, A., Broekhoven, M., Claessen, E., Rademaker, M. J., Munjishvili, L., Kruijne, E., Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases, Global Health, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Center of Experimental and Molecular Medicine, Graduate School, Medical Microbiology and Infection Prevention, Gastroenterology and Hepatology, APH - Health Behaviors & Chronic Diseases, Internal Medicine, Virology, Medical Microbiology & Infectious Diseases, Epidemiology, Pediatric Surgery, Pediatrics, Med Microbiol, Infect Dis & Infect Prev, MUMC+: MA Alg Interne Geneeskunde (9), MUMC+: DA MMI Staf (9), RS: CAPHRI - R4 - Health Inequities and Societal Participation, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, MUMC+: DA Medische Microbiologie en Infectieziekten (5), MUMC+: DA MMI Infectieserologie (9), and MUMC+: DA MMI AIOS (9)
- Subjects
Male ,Pediatrics ,Delayed Diagnosis ,Epidemiology ,General Practice ,Health Behavior ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,HIV Infections ,Logistic regression ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Ethnicity ,030212 general & internal medicine ,Young adult ,Netherlands ,Transients and Migrants ,Age Factors ,Prenatal Care ,General Medicine ,Middle Aged ,Hospitals ,Cohort ,Disease Progression ,Female ,0305 other medical science ,Sexuality ,Cohort study ,Adult ,medicine.medical_specialty ,Emigrants and Immigrants ,Prenatal care ,03 medical and health sciences ,Young Adult ,Acquired immunodeficiency syndrome (AIDS) ,SDG 3 - Good Health and Well-being ,medicine ,Humans ,Socioeconomic status ,030505 public health ,business.industry ,Research ,medicine.disease ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,business ,Demography - Abstract
Contains fulltext : 172538.pdf (Publisher’s version ) (Open Access) OBJECTIVES: Early testing for HIV and entry into care are crucial to optimise treatment outcomes of HIV-infected patients and to prevent spread of HIV. We examined risk factors for presentation with late or advanced disease in HIV-infected patients in the Netherlands. METHODS: HIV-infected patients registered in care between January 1996 and June 2014 were selected from the ATHENA national observational HIV cohort. Risk factors for late presentation and advanced disease were analysed by multivariable logistic regression. Furthermore, geographical differences and time trends were examined. RESULTS: Of 20 965 patients, 53% presented with late-stage HIV infection, and 35% had advanced disease. Late presentation decreased from 62% (1996) to 42% (2013), while advanced disease decreased from 46% to 26%. Late presentation only declined significantly among men having sex with men (MSM; p /=50 years (1.46; CI 1.33 to 1.60 vs 30-49 years), region of origin (South-East Asia 2.14; 1.80 to 2.54, sub-Saharan Africa 2.11; 1.88 to 2.36, Surinam 1.59; 1.37 to 1.84, Caribbean 1.31; 1.13 to 1.53, Latin America 1.23; 1.04 to 1.46 vs the Netherlands), and location of HIV diagnosis (hospital 3.27; 2.94 to 3.63, general practitioner 1.66; 1.50 to 1.83, antenatal screening 1.76; 1.38 to 2.34 vs sexually transmitted infection clinic). No association was found for socioeconomic status or level of urbanisation. Compared with Amsterdam, 2 regions had higher adjusted odds and 2 regions had lower odds of late presentation. Results were highly similar for advanced disease. CONCLUSIONS: Although the overall rate of late presentation is declining in the Netherlands, targeted programmes to reduce late HIV diagnoses remain needed for all risk groups, but should be prioritised for heterosexual males, migrant populations, people aged >/=50 years and certain regions in the Netherlands.
- Published
- 2016