Immune profile at HIV infection diagnosis: Evolution in the French Alps area over the last 20 years - 28/07/20
Profil immunologique au diagnostic de VIH : évolution dans les Alpes françaises sur les 20 dernières années
, S. Dufresne a, b, c, A. Valran a, b, d, C. Janssen a, b, d, P. Leclercq a, b, c, O. Epaulard a, b, cBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 5 |
| Iconographies | 2 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | We observed higher CD4 count at HIV diagnosis over the last 20 years in the MSM population of the area and a decreased proportion of late diagnoses, suggesting an improved time to diagnosis in this population. |
• | No change was observed in terms of time to diagnosis in the two other groups, suggesting the partial failure of screening campaigns addressed to these populations. |
Abstract |
Objectives |
Health of HIV-infected people relies on early antiretroviral therapy, i.e. early diagnosis. We aimed to determine whether the characteristics at HIV diagnosis in two French medical centres changed over the last 20 years.
Patients and methods |
All individuals diagnosed with HIV infection in Grenoble University Hospital (N=814) and Annecy Hospital (N=246) between 1997 and 2015 were included. We collected age, country of birth, mode of transmission, CD4T cell count, CD4/CD8 ratio, and HIV viral load.
Results |
Among the 1060 patients (mean age 37.4±11 years, 70.2% of men), 42.5% were men having sex with men (MSM); 65.2% were born in France, and 24.4% were born in Africa. Mean CD4T cell count at diagnosis was 396±288/mm3 and was stable over the study period when considering all patients; when considering the MSM group, a significant increase over time was observed, with a mean increase of 7.3 CD4/mm3 per year (P<0.001). A higher CD4 count at diagnosis was observed after 2005 (400±289 vs 468±271/mm3, P=0.005). The proportion of MSM patients with a CD4 count<200/mm3 at diagnosis was lower after 2005 (14.7% after 2005 and 25.6% before, P=0.028) This was not observed in heterosexual patients (born in Africa or not).
Conclusion |
In the MSM population, CD4 count at diagnosis is higher after 2005, suggesting that screening campaigns have become more efficient. This was not observed in other populations, who should be better targeted in future strategies.
Le texte complet de cet article est disponible en PDF.Keywords : HIV, Diagnosis, MSM, Lymphocyte count
Plan
Vol 50 - N° 5
P. 428-432 - août 2020 Retour au numéro
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