Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996 2014: Results from a national observational cohort

Eline L.M. Op De Coul*, Ard Van Sighem, Kees Brinkman, Birgit H. Van Benthem, Marchina E. Van Der Ende, Suzanne Geerlings, Peter Reiss, J. M. Prins, T. W. Kuijpers, H. J. Scherpbier, J. T.M. Van Der Meer, F.W.N.M. Wit, M. H. Godfried, P. Reiss, T. Van Der Poll, F. J.B. Nellen, S. E. Geerlings, M. Van Vugt, D. Pajkrt, J. C. BosW. J. Wiersinga, M. Van Der Valk, A. Goorhuis, J. W. Hovius, J. Van Eden, A. Henderiks, A. M.H. Van Hes, M. Mutschelknauss, H. E. Nobel, F. J.J. Pijnappel, A. M. Westerman, S. Jurriaans, N. K.T. Back, H. L. Zaaijer, B. Berkhout, M. T.E. Cornelissen, C. J. Schinkel, X. V. Thomas, Admiraal De Ruyter Ziekenhuis, M. Van Den Berge, A. Stegeman, S. Baas, L. Hage De Looff, D. Versteeg, M. J.H. Pronk, H. S.M. Ammerlaan, E. M.H.M. Korsten-Vorstermans, E. S. De Munnik, J. Tjhie, M. C.A. Wegdam, A. M. Weijsenfeld, M. E. Van Der Ende, T. E.M.S. De Vries-Sluijs, E. C.M. Van Gorp, C. A.M. Schurink, J. L. Nouwen, A. Verbon, B. J.A. Rijnders, H. I. Bax, R. J. Hassing, M. Van Der Feltz, N. Bassant, J. E.A. Van Beek, M. Vriesde, L. M. Van Zonneveld, A. De Oude-Lubbers, H. J. Van Den Berg-Cameron, F. B. Bruinsma-Broekman, J. De Groot, M. De Zeeuw-De Man, M. J. Broekhoven-Kruijne, M. Schutten, A. D.M.E. Osterhaus, C. A.B. Boucher, G. J.A. Driessen, A. M.C. Van Rossum, L. C. Van Der Knaap, E. Visser, J. Branger, C. J.H.M. Duijf-Van De Ven, E. F. Schippers, C. Van Nieuwkoop, R. W. Brimicombe, J. M. VanJperen, G. Van Der Hut, P. F.H. Franck, A. Van Eeden, M. Groot, I. S. Kwa, J. W. Bouwhuis, A. G.W. Van Hulzen, P. C.J. Bor, P. Bloembergen, M. J.H.M. Wolfhagen, G. J.H.M. Ruijs, R. Soetekouw, L. M.M. Van Der Prijt, M. Schoemaker, W. A. Van Der Reijden, R. Jansen, B. L. Herpers, F. P. Kroon, S. M. Arend, M. G.J. De Boer, M. P. Bauer, H. Jolink, A. M. Vollaard, C. Moons, A. C.M. Kroes, K. Pogany, J. V. Smit, E. Smit, T. Van Niekerk, O. Pontesilli, A. Oude Lashof, D. Posthouwer, J. Schippers, R. Vergoossen, I. H. Loo, R. El Moussaoui, G. Van Twillert, J. W.T.Cohen Stuart, B. M.W. Diederen, F. A. Van Truijen-Oud, R. Jansen, L. B.S. Gelinck, C. Meerkerk, G. S. Wildenbeest, C. L. Jansen, D. P.F. Van Houte, S. Faber, C. E. Delsing, H. Heins, P. H.J. Frissen, W. L. Blok, W. E.M. Schouten, G. E.L. Van Den Berk, C. J. Brouwer, G. F. Geerders, K. Hoeksema, M. J. Kleene, I. B. Van Der Meché, A. J.M. Toonen, S. Wijnands, M. Keuter, A. J.A.M. Van Der Ven, Hjm Ter Hofstede, A. S.M. Dofferhoff, R. Van Crevel, M. E.W. Bosch, K. J.T. Grintjes-Huisman, B. J. Zomer, J. P. Van Der Berg, E. H. Gisolf, P. H.M. Van Bentum, N. Langebeek, C. M.A. Swanink, K. D. Lettinga, H. Sulman, E. Witte, S. M.E. Vrouenraets, F. N. Lauw, H. Paap, D. J. Vlasblom, A. W. Rosingh, A. E. Brouwer, M. Kuipers, R. M.W.J. Santegoets, B. Van Der Ven, A. G.M. Buiting, P. J. Kabel, H. G. Sprenger, E. H. Scholvinck, S. Van Assen, K. R. Wilting, Y. Stienstra, P. A. Van Der Meulen, D. A. De Weerd, A. Riezebos-Brilman, C. C. Van Leer-Buter, M. M.E. Schneider, T. Mudrikova, P. M. Ellerbroek, J. J. Oosterheert, J. E. Arends, R. E. Barth, M. W.M. Wassenberg, L. M. Laan, E. E.B. Van Oers-Hazelzet, J. Patist, S. Vervoort, R. Frauenfelder, F. Verduyn-Lunel, A. M.J. Wensing, M. A. Van Agtmael, R. M. Perenboom, M. Bomers, J. De Vocht, C. M.J.E. Vandenbroucke-Grauls, C. W. Ang, T. F.W. Wolfs, L. J. Bont, L. Gras, A. I. Van Sighem, C. Smit, M. Hillebregt, V. Kimmel, Y. Tong, R. Van Den Boogaard, P. Hoekstra, A. De Lang, M. Berkhout, S. Grivell, A. Jansen, M. Van Den Akker, D. Bergsma, C. Lodewijk, R. Meijering, B. Peeck, M. Raethke, C. Ree, R. Regtop, Y. Ruijs, M. Schoorl, E. Tuijn, L. Veenenberg, T. Woudstra, Y. Bakker, A. De Jong, M. Broekhoven, E. Claessen, M. J. Rademaker, L. Munjishvili, E. Kruijne

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Objectives: Early testing for HIV and entry into care are crucial to optimise treatment outcomes of HIV-infected patients and to prevent spread of HIV. We examined risk factors for presentation with late or advanced disease in HIV-infected patients in the Netherlands. Methods: HIV-infected patients registered in care between January 1996 and June 2014 were selected from the ATHENA national observational HIV cohort. Risk factors for late presentation and advanced disease were analysed by multivariable logistic regression. Furthermore, geographical differences and time trends were examined. Results: Of 20 965 patients, 53% presented with latestage HIV infection, and 35% had advanced disease. Late presentation decreased from 62% (1996) to 42% (2013), while advanced disease decreased from 46% to 26%. Late presentation only declined significantly among men having sex with men (MSM; p <0.001), but not among heterosexual males (p=0.08) and females (p=0.73). Factors associated with late presentation were: heterosexual male (adjusted OR (aOR), 1.59; 95% CI 1.44 to 1.75 vs MSM), injecting drug use (2.00; CI 1.69 to 2.38), age .50 years (1.46; CI 1.33 to 1.60 vs 30.49 years), region of origin (South-East Asia 2.14; 1.80 to 2.54, sub-Saharan Africa 2.11; 1.88 to 2.36, Surinam 1.59; 1.37 to 1.84, Caribbean 1.31; 1.13 to 1.53, Latin America 1.23; 1.04 to 1.46 vs the Netherlands), and location of HIV diagnosis (hospital 3.27; 2.94 to 3.63, general practitioner 1.66; 1.50 to 1.83, antenatal screening 1.76; 1.38 to 2.34 vs sexually transmitted infection clinic). No association was found for socioeconomic status or level of urbanisation. Compared with Amsterdam, 2 regions had higher adjusted odds and 2 regions had lower odds of late presentation. Results were highly similar for advanced disease. Conclusions: Although the overall rate of late presentation is declining in the Netherlands, targeted programmes to reduce late HIV diagnoses remain needed for all risk groups, but should be prioritised for heterosexual males, migrant populations, people aged ≥50 years and certain regions in the Netherlands.

Original languageEnglish
Article numbere009688
JournalBMJ Open
Volume6
Issue number1
DOIs
Publication statusPublished - 2016

Cite this

Op De Coul, E. L. M., Van Sighem, A., Brinkman, K., Van Benthem, B. H., Van Der Ende, M. E., Geerlings, S., ... Kruijne, E. (2016). Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996 2014: Results from a national observational cohort. BMJ Open, 6(1), [e009688]. https://doi.org/10.1136/bmjopen-2015-009688