Late-stage diagnosis of HIV infection in Brazilian children: evidence from two national cohort studies

• Autor(a) principal: Ramos Jr.,Alberto Novaes
• Data de Publicação: 2013
• Outros Autores: Matida,Luiza Harunari, Alencar,Carlos Henrique, Hearst,Norman, Heukelbach,Jorg
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Cadernos de Saúde Pública
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2013000700004
• topic: HIV; Delayed Diagnosis; Child

This study analyzed data from two consecutive retrospective cohort samples (1983 to 1998 and 1999 to 2002) of Brazilian children with AIDS (N = 1,758) through mother-to-child-transmission. Late-stage diagnosis (CDC category C) was investigated in relation to the following variables: year of birth, year of HIV diagnosis, and time periods related to changes in government treatment guidelines. Late-stage diagnosis occurred in 731 (41.6%) of cases and was more prevalent in infants under 12 months of age. The rate of late-stage diagnosis decreased from 48% to 36% between the two periods studied. We also observed a reduction in the proportion of late-stage diagnoses and the time lapse between HIV diagnosis and ART initiation. A significant association was found between timely diagnosis and having been born in recent years (OR = 0.62; p = 0.009) and year of HIV diagnosis (OR = 0.72; p = 0.002/OR = 0.62; p < 0.001). Infants under the age of 12 months were more likely to be diagnosed at a late stage than older children (OR = 1.70; p = 0.004). Despite advances, there is a need to improve the effectiveness of policies and programs focused on improving early diagnosis and management of HIV/AIDS.