The proportion of patients with late diagnosis decreased for MSM until 2005 and slightly increased thereafter. In migrants the proportion of patients with late diagnosis exceeded that in all other transmission groups in each year. The probabilities for late presentation among MSM, IDUs and migrants, and interactions with date of diagnosis are presented in Figure 2. Of the entire population, patients living in big cities with more than 500 000 citizens had a lower probability of late presentation (OR 0.83; 95% CI 0.76–0.92). Selleckchem GSK-3 inhibitor However, for heterosexuals living in big cities this probability was somewhat higher (OR
1.42; 95% CI 1.15–1.76). Female sex was associated with a lower probability for late presentation in heterosexuals (OR 0.65; 95% CI 0.54–0.78) and
migrants (OR 0.74; 95% CI 0.59–0.92) but with a higher probability for patients with unknown transmission risk (OR 1.30; 95% CI 1.02–1.65). A total of 8559 patients above the age of 15 years were treatment-naïve at the first contact at a centre participating in the ClinSurv cohort. Of these, 371 patients had transmission risks other than MSM, IDU, heterosexual, migrant and unknown and were not included in the analyses. A total of 854 patients had no available CD4 cell count before the initiation of ART and were excluded. A total of 437 patients had inconclusive or missing data on pre-therapy viral loads or documented viral loads of <500 copies/mL before initiating first-line ART. These patients were considered to be treatment-experienced or elite controllers who would www.selleckchem.com/screening/mapk-library.html not benefit from ART and were also excluded. Patients without information on CD4 cell counts were significantly less often heterosexual (P = 0.007) and more often had an unknown transmission risk (P < 0.001). Patients with missing CD4 cell counts had clinical AIDS slightly more often than patients with available CD4 cell counts (14.6% vs. 12.0%, respectively; P = 0.03) mafosfamide although no significant difference was noted for CDC stages A and B. Among 6897 eligible patients in the German ClinSurv cohort, 4007 patients (58.1%) had a CD4 count <350 cells/μL or clinical AIDS and were late presenters for care in the cohort.
A total of 2513 patients (36.4%) had a CD4 count <200 cells/μL or clinical AIDS and were presenters for care with advanced HIV disease. Overall, late presenters were significantly older than other patients (median 42 vs. 39 years, respectively; P < 0.001). A comparison of patient characteristics between patients with late presentation and early presentation is shown in Table 1. Among all patients, the proportion of late presenters for care ranged from 65.7% in 2005 to 38.0% in 2010. The highest proportion was observed in migrants in 2005 (75.7%) and the lowest in MSM in 2010 (33.1%; Fig. 3). Compared with MSM, the probability of late presentation was higher for migrants (OR 2.08; 95% CI 1.44–3.01), patients with unknown risk (OR 1.46; 95% CI 1.00–2.12) and heterosexuals (OR 1.37; 95% CI 0.99–1.