[Delayed diagnosis of HIV infection in the Spanish VACH cohort [1997-2002]].
OBJECTIVE
To study the prevalence of delayed diagnosis of HIV infection and associated factors.


METHODS
A cross sectional study of patients included in the Spanish VACH cohort who had been diagnosed with HIV infection between 1997 and 2002 was performed. Delayed diagnosis was defined as patients diagnosed with HIV infection and AIDS simultaneously or within the first month after the first positive serologic test, or those with a first CD4+ cell count below 200/ml. The epidemiological characteristics of these patients were compared with those of the remaining patients


RESULTS
Of 2,820 new cases of HIV infection, delayed diagnosis was found in 506 (18%). These patients differed from the remaining patients in their lower mean age and higher HIV viral load, as well as in their distribution by sex (higher proportion of males), occupational status, history of incarceration in prison, and HIV-risk transmission group. The median survival during follow-up was significantly lower among AIDS patients with a delayed diagnosis.


CONCLUSIONS
Delayed diagnosis remains a cause for concern in our environment, due to its magnitude and its association with mortality. Some epidemiological characteristics provide clues to guide future programs directed at increasing information and improving prevention.
Teira Cobo
Ramón
R
Servicio de Enfermedades Infecciosas, Hospital de Basurto, Bilbao, España. retira@hbas.osakidetza.net
Suárez Lozano
Ignacio
I
Santamaría Jáuregui
Juan Miguel
JM
Terrón Pernía
Alberto
A
Domingo Pedrol
Pere
P
González García
Juan
J
Cosín Ochaita
Jaime
J
Ribera Pascuet
Esteban
E
Sánchez
Trinitario
T
Roca Villanueva
Bernardino
B
Viciana Fernández
Pompeyo
P
García Alcalde
María Luisa
ML
Geijo Martínez
Paloma
P
Galindo Puerto
Pepa
P
Vergara Campos
Antonio
A
Lozano  de León Naranjo
Fernando
F
Muñoz Sánchez
Agustín
A
Tebas
Pablo
P
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D013997:Time Factors; D019562:Viral Load