Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021

BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

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Publication Details

Journal
Eurosurveillance
Published
2024-11-28
DOI
https://doi.org/10.2807/1560-7917.es.2024.29.48.2400138
Citations
5
Primary Topic
HIV/AIDS Research and Interventions
Type
article
Field-Weighted Citation Impact
1.95

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article

Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021

Periklis Panagopoulos, Vasileios Papastamopoulos, Dimitrios Basoulis, Panagiota Lourida et al.
5 citations
Eurosurveillance
HIV/AIDS Research and Interventions
1.95
article

Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021

Periklis Panagopoulos, Vasileios Papastamopoulos, Dimitrios Basoulis, Panagiota Lourida, Nikos Pantazis, Emmanouil Barbounakis, Konstantinos Alexakis, Elpida Mastrogianni, Vasileios Petrakis, Ioannis Katsarolis, Λεωνιδία Λεωνίδου, Mina Psichοgiou, Vana Sypsa, Symeon Metallidis, Maria Chini, Nikolaos V. Sipsas, Sotirios Roussos, Anastasia Antoniadou, Antonios Papadopoulos, Vasilios Paparizos, Konstantinos Protopapas, Theofilos Chrysanthidis, Diamantis P. Kofteridis, Varvara Vasalou, Markos Marangos, P. Palla
article en
5 citations

Abstract

BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

EurosurveillanceVol. 29(48)
National and Kapodistrian University of Athens (GR), AHEPA University Hospital (GR), General University Hospital of Patras (GR), Hellenic Red Cross (GR), Space Hellas (Greece) (GR), Laiko General Hospital of Athens (GR), Andreas Sygros Hospital (GR), University Hospital of Heraklion (GR), University General Hospital Attikon (GR), University Hospital of Alexandroupolis (GR), Evangelismos Hospital (GR)
Gilead Sciences
Good health and well-being
Openalex Percentile: Top 13%
HIV/AIDS Research and Interventions
1.95
DOIOpen Access PDFOpenAlex
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