Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India

We describe the CD4 lymphocyte count at HIV presentation in an HIV cohort from a rural district of India. The majority of patients were diagnosed for their HIV-related symptoms, although a sizeable proportion of women were diagnosed because of antenatal screening or for having an HIV-positive partne...

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Main Authors: Gerardo Alvarez-Uria, Manoranjan Midde, Raghavakalyan Pakam, Shanmugamari Kannan, Lakshminarayana Bachu, Praveen Kumar Naik
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Interdisciplinary Perspectives on Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2012/293795
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author Gerardo Alvarez-Uria
Manoranjan Midde
Raghavakalyan Pakam
Shanmugamari Kannan
Lakshminarayana Bachu
Praveen Kumar Naik
author_facet Gerardo Alvarez-Uria
Manoranjan Midde
Raghavakalyan Pakam
Shanmugamari Kannan
Lakshminarayana Bachu
Praveen Kumar Naik
author_sort Gerardo Alvarez-Uria
collection DOAJ
description We describe the CD4 lymphocyte count at HIV presentation in an HIV cohort from a rural district of India. The majority of patients were diagnosed for their HIV-related symptoms, although a sizeable proportion of women were diagnosed because of antenatal screening or for having an HIV-positive partner. Patients diagnosed of HIV for antenatal screening or having an HIV-positive sexual partner had higher CD4 lymphocyte count than patients having tuberculosis or HIV-related symptoms. The proportion of patients diagnosed with CD4 count <200 and <350 cells/mm3 were 46% and 68.7%, respectively, and these figures did not change during the five years of the study. Factors associated with late presentations were male sex, older age, not having a permanent house, and, in women, lower education and being a widow or separated. With the implementation of 2010 WHO guidelines, the number of newly diagnosed patients who will require HIV treatment will increase 13.8%. If the CD4 count threshold for initiating HIV treatment is increased from 350 to 500 cells/mm3, the number of patients in need of treatment would increase 15.7%. Therefore, new strategies for avoiding HIV late presentation are urgently needed in developing countries.
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spelling doaj-art-4ae26939c00e4d86b4a44fdb83a4bb642025-08-20T02:38:33ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982012-01-01201210.1155/2012/293795293795Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in IndiaGerardo Alvarez-Uria0Manoranjan Midde1Raghavakalyan Pakam2Shanmugamari Kannan3Lakshminarayana Bachu4Praveen Kumar Naik5Department of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaDepartment of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaDepartment of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaDepartment of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaDepartment of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaDepartment of Infectious Diseases, Rural Development Trust Hospital, Kadiri Road, Bathalapalli 515661, IndiaWe describe the CD4 lymphocyte count at HIV presentation in an HIV cohort from a rural district of India. The majority of patients were diagnosed for their HIV-related symptoms, although a sizeable proportion of women were diagnosed because of antenatal screening or for having an HIV-positive partner. Patients diagnosed of HIV for antenatal screening or having an HIV-positive sexual partner had higher CD4 lymphocyte count than patients having tuberculosis or HIV-related symptoms. The proportion of patients diagnosed with CD4 count <200 and <350 cells/mm3 were 46% and 68.7%, respectively, and these figures did not change during the five years of the study. Factors associated with late presentations were male sex, older age, not having a permanent house, and, in women, lower education and being a widow or separated. With the implementation of 2010 WHO guidelines, the number of newly diagnosed patients who will require HIV treatment will increase 13.8%. If the CD4 count threshold for initiating HIV treatment is increased from 350 to 500 cells/mm3, the number of patients in need of treatment would increase 15.7%. Therefore, new strategies for avoiding HIV late presentation are urgently needed in developing countries.http://dx.doi.org/10.1155/2012/293795
spellingShingle Gerardo Alvarez-Uria
Manoranjan Midde
Raghavakalyan Pakam
Shanmugamari Kannan
Lakshminarayana Bachu
Praveen Kumar Naik
Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
Interdisciplinary Perspectives on Infectious Diseases
title Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
title_full Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
title_fullStr Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
title_full_unstemmed Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
title_short Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India
title_sort factors associated with late presentation of hiv and estimation of antiretroviral treatment need according to cd4 lymphocyte count in a resource limited setting data from an hiv cohort study in india
url http://dx.doi.org/10.1155/2012/293795
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