Impact of late diagnosis of hiv infection on patient survival

Objective. Assessment of the impact of late diagnosis of HIV infection on patient survival and factors associated with deaths from causes related to the progression of HIV infection.

Materials and methods. The data of 1072 patients over 18 years old who were diagnosed with HIV infection for the first time in 2019 were analyzed. Socio-demographic and clinical data of patients, as well as death data were collected and analyzed. The follow-up period was from the moment of detection to November 2023. The criteria for late diagnosis were a CD4 cell count below 200 cells/mm³ and/or HIV infection stage 4, established within 3 months after detection of HIV infection. Extensive indicators (proportions, %), adjusted odds ratios (AORs) and their 95% CIs were calculated.

Results. During the follow-up period, 235 (21.9%) people died, including 95 people from causes associated with the progression of HIV infection. Using Cox regression, it was found that the risk of death from causes associated with the progression of HIV infection was increased by factors such as late diagnosis (adjusted odds ratio (aOR) 8.424; 95% CI 4.805–14.768), living in rural areas (aOR 2.210; 95% CI 1.294–3.774), and age (AOR 1.041; 95% CI 1.019–1.063). However, this risk was reduced when patients used antiretroviral therapy (aOR 0.159; 95% CI 0.097–0.261). The risks of death decreased among workers by 2.123 times (aOR 0.471; 95% CI 0.283–0.783), among pensioners by 3.554 times (aOR 0.281; 95% CI 0.089–0.891), compared with the unemployed.

Conclusion. Late diagnosis of HIV infection increases the risk of death from HIV/AIDS-related causes. In this regard, it is important to maximally improve access to counseling and screening testing for HIV infection for all population groups.