AIDSWEEKLY Plus; Monday, November 5, 2007
Staff Medical Writers

The study, carried out in Baltimore, MD, from 1990 through 2006, shows that HIV patients beginning HIV therapy have trended toward increasing levels of immunocompromise. This is probably an indicator that people are getting tested for HIV later after they've contracted the disease than in the past. Also, people in several key demographic groups are not any quicker now to seek care than they were in the past and some are even taking longer.

HIV is a disease that is most effectively treated if caught early in the course of the illness. Early treatment also helps to limit the spread of the virus from one person to another. For these reasons, HIV services in the United States have evolved over time to encourage people to be tested for HIV and seek treatment if infected.

The researchers, Jeanne Keruly, MS and Richard Moore, MD, of Johns Hopkins University School of Medicine in Baltimore, analyzed data from over 3,300 patients seeking HIV care from the Johns Hopkins HIV service. The data were examined both as a whole and as demographic subsets including gender, race, injecting drug use, men who have sex with men, and heterosexuals. They looked at the amount of time between a patient's diagnosis of HIV and the time when that person first sought care; and they looked at the patient's immune status at the time of first care. Ideally, they would have found trends that showed a decrease in the time between diagnosis and treatment and an increase in the immune status.

During the years analyzed, men—and in particular white men and men who have sex with men—did have a trend towards seeking care more quickly after receiving an initial diagnosis of HIV. For all men, the average length between diagnosis and presentation for care was 270 days at the beginning of the study, falling to 183 days by the end.

Women's times to seek treatment, on the other hand, stayed fairly constant. And, unfortunately, injection drug users had a dramatic increase in the time until treatment, from an average of 378 days at the beginning of the study to 630 days at the conclusion.

People in all but one of the demographic categories had a trend of increasing immunocompromise, an indicator of disease development. The level of immunocompromise was such that the person was at increased risk for a poorer clinical outcome from antiretroviral therapy than if they had presented earlier for care. Over time, patients were increasingly likely to present with AIDS or HIV symptoms. The exception was in the men who have sex with men category.

In light of what appears to have been a poor response to efforts to more rapidly diagnose and treat HIV patients in Maryland, the authors call for new strategies to provide earlier HIV testing and referral into care.

Keywords: HIV/AIDS, AIDS, Acquired Immunodeficiency Syndrome, HIV, Human Immunodeficiency Virus, Virology, Johns Hopkins University.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Keruly JC, Moore RD, Immune status at presentation to care did not improve among antiretroviral-naive persons from 1990 to 2006, Clin Infect Dis. 2007 Nov 15;45(10):1369-74.

PubMED Related articles Search

2007-11-05
AW071101

Copyright © 2007 - Charles Henderson, Publisher. All rights Reserved. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA. Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633-4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX: (205) 995-1588 http://www.newsrx.net

AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, Bridgestone/Firestone Charitable Trust, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2007. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright © 1980,2007. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.