title: Baseline CD4 cell counts of newly diagnosed HIV cases in China: 2006-2012.
abstract: BACKGROUND
  Late diagnosis of HIV infection is common. We aim to assess the proportion of newly diagnosed HIV cases receiving timely baseline CD4 count testing and the associated factors in China.
  
  
  METHODS
  Data were extracted from the Chinese HIV/AIDS Comprehensive Response Information Management System. Adult patients over 15 years old who had been newly diagnosed with HIV infection in China between 2006 and 2012 were identified. The study cohort comprised individuals who had a measured baseline CD4 count.
  
  
  RESULTS
  Among 388,496 newly identified HIV cases, the median baseline CD4 count was 294 cells/µl (IQR: 130-454), and over half (N = 130,442, 58.8%) were less than 350 cells/µl. The median baseline CD4 count increased from 221 (IQR: 63-410) in 2006 to 314 (IQR: 159-460) in 2012. A slight majority of patients (N = 221,980, 57.1%) received baseline CD4 count testing within 6 months of diagnosis. The proportion of individuals who received timely baseline CD4 count testing increased significantly from 20.0% in 2006 to 76.9% in 2012. Factors associated with failing to receiving timely CD4 count testing were: being male (OR: 1.17, 95% CI: 1.15-1.19), age 55 years or older (OR:1.03, 95% CI: 1.00-1.06), educational attainment of primary school education or below (OR: 1.30, 95% CI: 1.28-1.32), infection with HIV through injection drug use (OR: 2.07, 95% CI: 2.02-2.12) or sexual contact and injection drug use (OR: 1.87, 95% CI: 1.76-1.99), diagnosis in a hospital (OR: 1.91, 95% CI: 1.88-1.95) or in a detention center (OR: 1.75, 95% CI: 1.70-1.80), and employment as a migrant worker (OR:1.55, 95% CI:1.53-1.58).
  
  
  CONCLUSIONS
  The proportion of newly identified HIV patients receiving timely baseline CD4 testing has increased significantly in China from 2006-2012. Continued effort is needed for further promotion of early HIV diagnosis and timely baseline CD4 cell count testing.
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Houlin
authors.initials: H
authors.lastname: Tang
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yurong
authors.initials: Y
authors.lastname: Mao
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Epidemiology, School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
authors.forename: Cynthia X
authors.initials: CX
authors.lastname: Shi
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Han
authors.affiliation: Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xu
authors.affiliation: Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Qin
authors.affiliation: Department of Epidemiology, School of Public Health, University of California at Los Angeles, California, United States of America.
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
authors.affiliation: Division of Integration and Evaluation, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000266:history / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062486:Public Health Surveillance; D012307:Risk Factors; D055815:Young Adult