HIV infection diagnosis – What changed in 10 years

Abstract

Introduction: The HIV infection / AIDS is still an important cause
of morbidity and mortality in developing countries, where only a
restricted number of patients have antiretroviral therapy available.
In developed countries there is a trend to epidemics stabilization.
Nevertheless, late stage diagnosis is still very frequent, overcoming the benefits of treatment early onset. Portugal is the Western
European country with the highest prevalence of HIV infection,
presenting an increasing number of new cases.
Objective and Methods: We retrospectively characterized and
compared two groups of patients with HIV infection followed in
an outpatient clinic of a Lisbon hospital. The first group included
patients that had been diagnosed in 1997/1998, and the second
group included patients diagnosed in 2007/2008. Our purpose
was to ascertain any differences between the groups concerning
demography, epidemiology, clinical presentation, laboratory parameters and therapy.
Results: We evaluated 74 patients diagnosed with HIV infection
in 1997/1998 and 106 diagnosed in 2007/2008. The average
age at the time of diagnosis was higher in 2007/2008 (37.8 vs
33.1 years). The male gender was predominant in both periods,
without significant difference. There were more foreign patients
in 2007/2008 (50% vs. 20.3%). There was an increase in
heterosexual transmission (65.1% vs. 48.6%) and a decreased
number of cases associated with injection drug use (3.8% vs.
32.4%) in 2007/2008. There were no significant differences of
patients diagnosed on initial stage C between the two groups. In
the 1997/1998 period, patients needed to take a higher number
of pills distributed by a higher number of times per day.
Conclusions: The investment in strategies to reduce the risk
of HIV transmission and early diagnosis is crucial. With a more
effective prevention and an early institution of antiretroviral therapy, we expect to become more effective, easier and safer, day
by day, and perhaps one day we will achieve the epidemic control.
Key words: HIV infection, AIDS, epidemiology, transmission,
prevention, behaviour, antiretroviral therapy.