title: Epidemiological Profile of Newly Diagnosed HIV-Infected Patients in Northern Paris: A Retrospective Study.
abstract: In attempt to identify the factors associated with delayed diagnosis during HIV infection, we studied retrospectively the epidemiological profile of HIV-infected patients diagnosed between January 1, 2012 and December 31, 2013 and followed in our clinical center in Paris. Data were compared to those obtained at the same site during the year 2003. One hundred eighty-six patients fulfilled the inclusion criteria: 49 (26%) had a CD4 count <200/mm3at diagnosis. Compared to subjects with CD4 count ≥200/mm3, advanced patients were older, had a higher plasma viral load, had more often an AIDS-defining event at the time of HIV diagnosis (45% vs. 3%), had been infected more often through heterosexual contact (69% vs. 44%), had less frequently past HIV testing (23% vs. 63%), and tended to live in less favorable conditions. A higher proportion of these patients initiated antiretroviral therapy in the 3 months following diagnosis (93.9% vs. 48.1%). Compared to data obtained in 161 patients in 2003, the proportions of advanced patients were similar between the two periods (26% vs. 22%). There was a significant increase from year 2003 to the 2012-2013 period in the proportion of men who have sex with men (MSM) (50% vs. 27%) and in the percentage of patients infected with HIV-1 subtype B (48% vs. 27%) and with positive syphilis serology (22% vs. 8%). Our data show that (1) HIV screening should be extended to populations with the following characteristics: older age, heterosexuality, and low socioeconomic level, and (2) HIV transmission continues to progress in MSM, arguing for the value of preexposure prophylaxis.
authors.affiliation: 1 Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France .
authors.forename: Olivia
authors.initials: O
authors.lastname: Senard
authors.affiliation: 2 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Service de Biostatistique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France .
authors.forename: Charles
authors.initials: C
authors.lastname: Burdet
authors.affiliation: 3 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Benoit
authors.initials: B
authors.lastname: Visseaux
authors.affiliation: 3 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.affiliation: 1 Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France .
authors.forename: Sylvie
authors.initials: S
authors.lastname: Le Gac
authors.affiliation: 1 Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France .
authors.forename: Zélie
authors.initials: Z
authors.lastname: Julia
authors.affiliation: 1 Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France .
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lariven
authors.affiliation: 3 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Diane
authors.initials: D
authors.lastname: Descamps
authors.affiliation: 4 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.affiliation: 4 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Patrick
authors.initials: P
authors.lastname: Yeni
authors.affiliation: 4 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France .
authors.forename: Véronique
authors.initials: V
authors.lastname: Joly
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D015497:HIV-1 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D010949:Plasma / Q000821:virology; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; advanced disease; epidemiology