Late diagnosis of HIV: An updated consensus definition
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Late diagnosis of HIV : An updated consensus definition. / The EuroTEST HIV Late Diagnosis Definition Working Group.
I: HIV Medicine, Bind 23, Nr. 11, 2022, s. 1202-1208.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Late diagnosis of HIV
T2 - An updated consensus definition
AU - Croxford, Sara
AU - Stengaard, Annemarie Rinder
AU - Brännström, Johanna
AU - Combs, Lauren
AU - Dedes, Nikos
AU - Girardi, Enrico
AU - Grabar, Sophie
AU - Kirk, Ole
AU - Kuchukhidze, Giorgi
AU - Lazarus, Jeffrey V.
AU - Noori, Teymur
AU - Pharris, Anastasia
AU - Raben, Dorthe
AU - Rockstroh, Jürgen K.
AU - Simões, Daniel
AU - Sullivan, Ann K.
AU - Van Beckhoven, Dominique
AU - Delpech, Valerie C.
AU - The EuroTEST HIV Late Diagnosis Definition Working Group
N1 - Publisher Copyright: © 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
PY - 2022
Y1 - 2022
N2 - Introduction: In recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation ('presenting for care with a CD4 count < 350 cells/μL or an AIDS-defining event, regardless of CD4 count') these individuals would be incorrectly assigned as being diagnosed late. Methods: In spring 2022, a European expert group convened to revise the current late HIV presentation consensus definition. A survey on data availability to apply this revised definition was sent to nominated European focal points responsible for HIV surveillance (n = 53). Results: Experts agreed that the updated definition should refer to late HIV diagnosis rather than presentation and include the following addition: People with evidence of recent infection should be reclassified as 'not late', with evidence of recent infection considered hierarchically. The individual must have: (i) laboratory evidence of recent infection; (ii) a last negative HIV test within 12 months of diagnosis; or (iii) clinical evidence of acute infection. People with evidence of being previously diagnosed abroad should be excluded. A total of 18 countries responded to the survey; 83% reported capturing CD4 count and/or AIDS at diagnosis through national surveillance, 67% captured last negative test and/or previous HIV diagnosis, 61% captured seroconversion illness at diagnosis and 28% captured incident antibody results. Conclusions: Accurate data on late diagnosis are important to describe the effects of testing programmes. Reclassification of individuals with recent infection will help to better identify populations most at risk of poor HIV outcomes and areas for intervention.
AB - Introduction: In recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation ('presenting for care with a CD4 count < 350 cells/μL or an AIDS-defining event, regardless of CD4 count') these individuals would be incorrectly assigned as being diagnosed late. Methods: In spring 2022, a European expert group convened to revise the current late HIV presentation consensus definition. A survey on data availability to apply this revised definition was sent to nominated European focal points responsible for HIV surveillance (n = 53). Results: Experts agreed that the updated definition should refer to late HIV diagnosis rather than presentation and include the following addition: People with evidence of recent infection should be reclassified as 'not late', with evidence of recent infection considered hierarchically. The individual must have: (i) laboratory evidence of recent infection; (ii) a last negative HIV test within 12 months of diagnosis; or (iii) clinical evidence of acute infection. People with evidence of being previously diagnosed abroad should be excluded. A total of 18 countries responded to the survey; 83% reported capturing CD4 count and/or AIDS at diagnosis through national surveillance, 67% captured last negative test and/or previous HIV diagnosis, 61% captured seroconversion illness at diagnosis and 28% captured incident antibody results. Conclusions: Accurate data on late diagnosis are important to describe the effects of testing programmes. Reclassification of individuals with recent infection will help to better identify populations most at risk of poor HIV outcomes and areas for intervention.
KW - definition
KW - diagnosis
KW - HIV
KW - late presentation
KW - monitoring
U2 - 10.1111/hiv.13425
DO - 10.1111/hiv.13425
M3 - Journal article
C2 - 36347523
AN - SCOPUS:85141688500
VL - 23
SP - 1202
EP - 1208
JO - HIV Medicine
JF - HIV Medicine
SN - 1464-2662
IS - 11
ER -
ID: 335055819