Original Research Article
Year: 2020 | Month: July | Volume: 10 | Issue: 7 | Pages: 160-167
Incidence of Late Presentation and Advanced disease in Newly Diagnosed Patients of HIV infection in Dhofar region of Oman
Akhwand Shakeel Ahmad
Senior Specialist Medicine, Sultan Qaboos Hospital, Salalah, Oman
ABSTRACT
Objectives: Globally half of the patients with new HIV infection are diagnosed late. This study was carried out to assess incidence of late diagnosis and its impact in newly-diagnosed HIV patients in Dhofar region of Oman.
Methods: The medical records of the patients diagnosed to have new HIV infection during the years2018 and 2019 were scanned to find out incidence of late (CD4<350) or advanced disease (CD4<200) on presentation and whether diagnosed by screening or related symptoms.
Results: Among 46 new HIV infections during 2018-2019, 63% (29/46) were between age 31-50 years, 23.9% (11/46) were females, 37% (17/46) were unmarried and 37% (17/46) were MSM. Only 8 (17.4%) had CD4 count >350, while 38 (82.6%) were in late categories including 13 (28.3%) late-presenters and25 (54.3%) with advanced disease. The unmarried and those above 50 had a tendency to present late. Twenty-eight (60.9%) patients were asymptomatic. The patients presenting with HIV-related symptoms had either late or advanced disease, but the probability of being diagnosed in an advanced state was statistically significant (p 0.003; OR 9; 95% CI 2.09-38.79). Patients with advanced disease required 352 days of hospitalization including 72 days in ICU, and 20% (5/25) of them who had CD4<20 died. Nineteen (41.3%) patients had missed opportunity for early diagnosis when they attended the hospital in last 2 years; 28.3% (13/46) had multiple visits.
Conclusion: Late diagnosis in HIV infection is common. Screening strategies for HIV should be revised.
Key words: HIV; AIDS; Newly-diagnosed HIV; late-presentation HIV; advanced HIV disease; missed opportunities;CD4;Oman