Format

Send to

Choose Destination
BMJ Open. 2016 Jan 4;6(1):e009688. doi: 10.1136/bmjopen-2015-009688.

Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996-2014: results from a national observational cohort.

Collaborators (297)

Prins JM, Kuijpers TW, Scherpbier HJ, van der Meer JT, Wit FW, Godfried MH, Reiss P, van der Poll T, Nellen FJ, Geerlings SE, van Vugt M, Pajkrt D, Bos JC, Wiersinga WJ, van der Valk M, Goorhuis A, Hovius JW, van Eden J, Henderiks A, van Hes AM, Mutschelknauss M, Nobel HE, Pijnappel FJ, Westerman AM, Jurriaans S, Back NK, Zaaijer HL, Berkhout B, Cornelissen MT, Schinkel CJ, Thomas XV, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Versteeg D, Pronk MJ, Ammerlaan HS, Korsten-Vorstermans EM, de Munnik ES, Jansz AR, Tjhie J, Wegdam MC, van der Plas A, Weijsenfeld AM, van der Ende ME, de Vries-Sluijs TE, van Gorp EC, Schurink CA, Nouwen JL, Verbon A, Rijnders BJ, Bax HI, Hassing RJ, van der Feltz M, Bassant N, van Beek JE, Vriesde M, van Zonneveld LM, de Oude-Lubbers A, van den Berg-Cameron HJ, Bruinsma-Broekman FB, de Groot J, de Zeeuw-de Man M, Broekhoven-Kruijne M, Schutten M, Osterhaus AD, Boucher CA, Driessen GJ, van Rossum AM, van der Knaap LC, Visser E, Branger J, Duijf-van de Ven CJ, Schippers EF, van Nieuwkoop C, Brimicombe RW, van IJperen JM, van der Hut G, Franck PF, van Eeden A, Brokking W, Groot M, Damen M, Groeneveld PH, Bouwhuis JW, van den Berg JF, van Hulzen AG, van der Bliek GL, Bor PC, Bloembergen P, Wolfhagen MJ, Ruijs GJ, van Lelyveld SF, Soetekouw R, Hulshoff N, van der Prijt LM, Schoemaker M, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Kroon FP, Arend SM, de Boer M, Bauer MP, Jolink H, Vollaard AM, Dorama W, Moons C, Claas EC, Kroes AC, den Hollander JG, Pogany K, Kastelijns M, Smit JV, Smit E, Bezemer M, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof A, Posthouwer D, Ackens RP, Schippers J, Vergoossen R, Weijenberg Maes B, Savelkoul PH, Loo IH, Weijer S, El Moussaoui R, Heitmuller M, Heitmuller M, Kortmann W, van Twillert G, Pronk D, van Truijen-Oud FA, van der Reijden WA, Jansen R, Leyten EM, Gelinck LB, van Hartingsveld A, Meerkerk C, Wildenbeest GS, Mutsaers JA, Jansen CL, van Vonderen MG, van Houte DP, Dijkstra K, Faber S, Weel J, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Heins H, Lucas E, Brinkman K, Frissen PH, Blok WL, Schouten WE, van den Berk GE, Bosma AS, Brouwer CJ, Geerders GF, Hoeksema K, Kleene MJ, van der Meché IB, Toonen AJ, Wijnands S, van Ogtrop ML, Koopmans PP, Keuter M, van der Ven AJ, Ter Hofstede HJ, Dofferhoff AS, van Crevel R, Albers M, Bosch ME, Grintjes-Huisman KJ, Zomer BJ, Stelma FF, Burger D, Richter C, van der Berg JP, Gisolf EH, Ter Beest G, van Bentum PH, Langebeek N, Tiemessen R, Swanink CM, Veenstra J, Lettinga KD, Spelbrink M, Sulman H, Spelbrink M, Witte E, Damen M, Peerbooms PG, Mulder JW, Vrouenraets SM, Lauw FN, van Broekhuizen MC, Paap H, Vlasblom DJ, Oudmaijer Sanders E, Smits PH, Rosingh AW, Verhagen DW, Geilings J, van Kasteren ME, Brouwer AE, de Kruijf-van de Wiel BA, Kuipers M, Santegoets RM, van der Ven B, Marcelis JH, Buiting AG, Kabel PJ, Bierman WF, Sprenger HG, Scholvinck EH, van Assen S, Wilting KR, Stienstra Y, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HG, Riezebos-Brilman A, van Leer-Buter CC, Schneider MM, Mudrikova T, Ellerbroek PM, Oosterheert JJ, Arends JE, Barth RE, Wassenberg MW, van Elst-Laurijssen DH, Laan LM, van Oers-Hazelzet EE, Patist J, Vervoort S, Nieuwenhuis HE, Frauenfelder R, Schuurman R, Verduyn-Lunel F, Wensing AM, Peters EJ, van Agtmael MA, Perenboom RM, Bomers M, de Vocht J, Elsenburg LJ, Pettersson AM, Vandenbroucke-Grauls CM, Ang CW, Geelen SP, Wolfs T, Bont LJ, Nauta N, Bezemer DO, Gras L, van Sighem AI, Smit C, Zaheri S, Hillebregt M, Kimmel V, Tong Y, Lascaris B, van den Boogaard R, Hoekstra P, de Lang A, Berkhout M, Grivell S, Jansen A, de Groot L, 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 MJ, Munjishvili L, Kruijne E, Tuk B.

Author information

1
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
2
Stichting HIV Monitoring, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
3
Department of Internal Medicine, OLVG, Amsterdam, The Netherlands.
4
Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
5
Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.

Abstract

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 <0.001), but not among heterosexual males (p=0.08) and females (p=0.73). Factors associated with late presentation were: heterosexual male (adjusted OR (aOR), 1.59; 95% CI 1.44 to 1.75 vs MSM), injecting drug use (2.00; CI 1.69 to 2.38), age ≥ 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.

KEYWORDS:

EPIDEMIOLOGY

PMID:
26729389
PMCID:
PMC4716151
DOI:
10.1136/bmjopen-2015-009688
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center