. 2016 Jan 4;6(1):e009688.

doi: 10.1136/bmjopen-2015-009688.

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 Coul¹, Ard van Sighem², Kees Brinkman³, Birgit H van Benthem¹, Marchina E van der Ende⁴, Suzanne Geerlings⁵, Peter Reiss²; ATHENA National Observational HIV Cohort

Collaborators, Affiliations

Collaborators

ATHENA National Observational HIV Cohort:
J M Prins, T W Kuijpers, H J Scherpbier, J T M van der Meer, F W M N Wit, M H Godfried, P Reiss, T van der Poll, F J B Nellen, S E Geerlings, M van Vugt, D Pajkrt, J C Bos, W 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, 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, A R Jansz, J Tjhie, M C A Wegdam, A van der Plas, 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 van IJperen, G van der Hut, P F H Franck, A van Eeden, W Brokking, M Groot, M Damen, P H P Groeneveld, J W Bouwhuis, J F van den Berg, A G W van Hulzen, G L van der Bliek, P C J Bor, P Bloembergen, M J H M Wolfhagen, G J H M Ruijs, S F L van Lelyveld, R Soetekouw, N Hulshoff, L M M van der Prijt, M Schoemaker, N Bermon, 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, W Dorama, C Moons, E C J Claas, A C M Kroes, J G den Hollander, K Pogany, M Kastelijns, J V Smit, E Smit, M Bezemer, T van Niekerk, O Pontesilli, S H Lowe, A Oude Lashof, D Posthouwer, R P Ackens, J Schippers, R Vergoossen, B Weijenberg Maes, P H M Savelkoul, I H Loo, S Weijer, R El Moussaoui, M Heitmuller, M Heitmuller, W Kortmann, G van Twillert, D Pronk, F A van Truijen-Oud, W A van der Reijden, R Jansen, E M S Leyten, L B S Gelinck, A van Hartingsveld, C Meerkerk, G S Wildenbeest, J A E M Mutsaers, C L Jansen, M G A van Vonderen, D P F van Houte, K Dijkstra, S Faber, J Weel, G J Kootstra, C E Delsing, M van der Burg-van de Plas, H Heins, E Lucas, K Brinkman, P H J Frissen, W L Blok, W E M Schouten, G E L van den Berk, A S Bosma, C J Brouwer, G F Geerders, K Hoeksema, M J Kleene, I B van der Meché, A J M Toonen, S Wijnands, M L van Ogtrop, P P Koopmans, M Keuter, A J A M van der Ven, H J M Ter Hofstede, A S M Dofferhoff, R van Crevel, M Albers, M E W Bosch, K J T Grintjes-Huisman, B J Zomer, F F Stelma, D Burger, C Richter, J P van der Berg, E H Gisolf, G Ter Beest, P H M van Bentum, N Langebeek, R Tiemessen, C M A Swanink, J Veenstra, K D Lettinga, M Spelbrink, H Sulman, M Spelbrink, E Witte, M Damen, P G H Peerbooms, J W Mulder, S M E Vrouenraets, F N Lauw, M C van Broekhuizen, H Paap, D J Vlasblom, E Oudmaijer Sanders, P H M Smits, A W Rosingh, D W M Verhagen, J Geilings, M E E van Kasteren, A E Brouwer, B A F M de Kruijf-van de Wiel, M Kuipers, R M W J Santegoets, B van der Ven, J H Marcelis, A G M Buiting, P J Kabel, W F W Bierman, H G Sprenger, E H Scholvinck, S van Assen, K R Wilting, Y Stienstra, H de Groot-de Jonge, P A van der Meulen, D A de Weerd, H G M Niesters, 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, D H M van Elst-Laurijssen, L M Laan, E E B van Oers-Hazelzet, J Patist, S Vervoort, H E Nieuwenhuis, R Frauenfelder, R Schuurman, F Verduyn-Lunel, A M J Wensing, E J G Peters, M A van Agtmael, R M Perenboom, M Bomers, J de Vocht, L J M Elsenburg, A M Pettersson, C M J E Vandenbroucke-Grauls, C W Ang, S P M Geelen, T F W Wolfs, L J Bont, N Nauta, D O Bezemer, L Gras, A I van Sighem, C Smit, S Zaheri, M Hillebregt, V Kimmel, Y Tong, B Lascaris, R van den Boogaard, P Hoekstra, A de Lang, M Berkhout, S Grivell, A Jansen, L de Groot, 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, B Tuk

Affiliations

¹ Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
² Stichting HIV Monitoring, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
³ Department of Internal Medicine, OLVG, Amsterdam, The Netherlands.
⁴ Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
⁵ Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.

PMID: 26729389
PMCID: PMC4716151
DOI: 10.1136/bmjopen-2015-009688

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 et al. BMJ Open. 2016.

. 2016 Jan 4;6(1):e009688.

doi: 10.1136/bmjopen-2015-009688.

Authors

Eline L M Op de Coul¹, Ard van Sighem², Kees Brinkman³, Birgit H van Benthem¹, Marchina E van der Ende⁴, Suzanne Geerlings⁵, Peter Reiss²; ATHENA National Observational HIV Cohort

Collaborators

ATHENA National Observational HIV Cohort:
J M Prins, T W Kuijpers, H J Scherpbier, J T M van der Meer, F W M N Wit, M H Godfried, P Reiss, T van der Poll, F J B Nellen, S E Geerlings, M van Vugt, D Pajkrt, J C Bos, W 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, 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, A R Jansz, J Tjhie, M C A Wegdam, A van der Plas, 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 van IJperen, G van der Hut, P F H Franck, A van Eeden, W Brokking, M Groot, M Damen, P H P Groeneveld, J W Bouwhuis, J F van den Berg, A G W van Hulzen, G L van der Bliek, P C J Bor, P Bloembergen, M J H M Wolfhagen, G J H M Ruijs, S F L van Lelyveld, R Soetekouw, N Hulshoff, L M M van der Prijt, M Schoemaker, N Bermon, 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, W Dorama, C Moons, E C J Claas, A C M Kroes, J G den Hollander, K Pogany, M Kastelijns, J V Smit, E Smit, M Bezemer, T van Niekerk, O Pontesilli, S H Lowe, A Oude Lashof, D Posthouwer, R P Ackens, J Schippers, R Vergoossen, B Weijenberg Maes, P H M Savelkoul, I H Loo, S Weijer, R El Moussaoui, M Heitmuller, M Heitmuller, W Kortmann, G van Twillert, D Pronk, F A van Truijen-Oud, W A van der Reijden, R Jansen, E M S Leyten, L B S Gelinck, A van Hartingsveld, C Meerkerk, G S Wildenbeest, J A E M Mutsaers, C L Jansen, M G A van Vonderen, D P F van Houte, K Dijkstra, S Faber, J Weel, G J Kootstra, C E Delsing, M van der Burg-van de Plas, H Heins, E Lucas, K Brinkman, P H J Frissen, W L Blok, W E M Schouten, G E L van den Berk, A S Bosma, C J Brouwer, G F Geerders, K Hoeksema, M J Kleene, I B van der Meché, A J M Toonen, S Wijnands, M L van Ogtrop, P P Koopmans, M Keuter, A J A M van der Ven, H J M Ter Hofstede, A S M Dofferhoff, R van Crevel, M Albers, M E W Bosch, K J T Grintjes-Huisman, B J Zomer, F F Stelma, D Burger, C Richter, J P van der Berg, E H Gisolf, G Ter Beest, P H M van Bentum, N Langebeek, R Tiemessen, C M A Swanink, J Veenstra, K D Lettinga, M Spelbrink, H Sulman, M Spelbrink, E Witte, M Damen, P G H Peerbooms, J W Mulder, S M E Vrouenraets, F N Lauw, M C van Broekhuizen, H Paap, D J Vlasblom, E Oudmaijer Sanders, P H M Smits, A W Rosingh, D W M Verhagen, J Geilings, M E E van Kasteren, A E Brouwer, B A F M de Kruijf-van de Wiel, M Kuipers, R M W J Santegoets, B van der Ven, J H Marcelis, A G M Buiting, P J Kabel, W F W Bierman, H G Sprenger, E H Scholvinck, S van Assen, K R Wilting, Y Stienstra, H de Groot-de Jonge, P A van der Meulen, D A de Weerd, H G M Niesters, 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, D H M van Elst-Laurijssen, L M Laan, E E B van Oers-Hazelzet, J Patist, S Vervoort, H E Nieuwenhuis, R Frauenfelder, R Schuurman, F Verduyn-Lunel, A M J Wensing, E J G Peters, M A van Agtmael, R M Perenboom, M Bomers, J de Vocht, L J M Elsenburg, A M Pettersson, C M J E Vandenbroucke-Grauls, C W Ang, S P M Geelen, T F W Wolfs, L J Bont, N Nauta, D O Bezemer, L Gras, A I van Sighem, C Smit, S Zaheri, M Hillebregt, V Kimmel, Y Tong, B Lascaris, R van den Boogaard, P Hoekstra, A de Lang, M Berkhout, S Grivell, A Jansen, L de Groot, 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, B Tuk

Affiliations

¹ Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
² Stichting HIV Monitoring, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
³ Department of Internal Medicine, OLVG, Amsterdam, The Netherlands.
⁴ Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
⁵ Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.

PMID: 26729389
PMCID: PMC4716151
DOI: 10.1136/bmjopen-2015-009688

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 late-stage 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.

Keywords: EPIDEMIOLOGY.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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Figures

**Figure 1**
Percentages of late presentation (CD4<350 cells/mm³ or AIDS-defining event regardless of CD4 count) for 2010–2014, by transmission group (men having sex with men (MSM), heterosexual male, female) and region of origin.

**Figure 2**
Percentages of late presentation (CD4<350 cells/mm³ or AIDS-defining event regardless of CD4 count), by year of diagnosis and transmission group (MSM, men having sex with men).

**Figure 3**
(A) Percentages of late presentation (CD4<350 cells/mm³ or AIDS-defining event regardless of CD4 count) in 2010–2014 in the Netherlands, by public health region (overall population). (B) Percentages of late presentation (CD4<350 cells/mm³ or AIDS-defining event regardless of CD4 count) in 2010–2014 in the Netherlands, by public health region (men having sex with men (MSM) only).

See this image and copyright information in PMC

References

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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources