Sociobehavioral Risk Factors and Clinical Implications of Late Presentation Among People Living with HIV in the Brazilian Amazon Region.
Leonn Mendes Soares PereiraEliane Dos Santos FrançaIran Barros CostaIgor Tenório LimaAmaury Bentes Cunha FreireFrancisco Lúzio de Paula RamosTalita Antonia Furtado MonteiroOlinda MacedoRita Catarina Medeiros SousaFelipe Bonfim FreitasIgor Brasil CostaAntonio Carlos Rosário VallinotoPublished in: AIDS and behavior (2024)
This study aimed to analyze the prevalence, sociobehavioral factors and clinical-laboratory consequences of late presentation among people living with HIV (PLHIV) in the Brazilian Amazon region. In total, 402 HIV + individuals treated at reference units in Belém city (Pará, Brazil) between 2018 and 2019 were evaluated. Late presentation was defined as a first-collection LTCD4 + count below 350 cells/µL. Sociodemographic, behavioral and clinical data were obtained from questionnaires or medical records. Th1, Th2 and Th17 cytokine profiles were evaluated by flow cytometry. Longitudinal data on viral load, T lymphocytes, and antiretroviral therapy administration were obtained from control and logistic databases. Approximately 52.73% of the participants were late presenters and sought medical care 7-12 + months after their primary HIV diagnosis. Sociobehavioral factors associated with late presentation included illicit drug use for more than 5 years, polyamory, no alcohol consumption, homosexuality, and sexual inactiveness after HIV diagnosis. Clinically, late presentation was associated with coinfection rate; polysymptomatology; high IFN-ɣ, IL-6 and IL-10 levels; nonresponse to antiretroviral therapy; and virological failure- and tuberculosis coinfection-motivated changes to therapy. In summary, the prevalence of late presentation in Pará in the Brazilian Amazon region is high. Delays in seeking specialized care after a primary HIV diagnosis cause medium/long-term changes in the life expectancy and health of PLHIV.
Keyphrases
- antiretroviral therapy
- hiv infected
- hiv positive
- human immunodeficiency virus
- hiv aids
- hiv infected patients
- risk factors
- healthcare
- hiv testing
- case report
- men who have sex with men
- mental health
- alcohol consumption
- flow cytometry
- hepatitis c virus
- big data
- south africa
- palliative care
- mycobacterium tuberculosis
- induced apoptosis
- oxidative stress
- dendritic cells
- emergency department
- risk assessment
- newly diagnosed
- machine learning
- cell therapy