Data Completeness and Recorded Advanced HIV Categories in a Regional Registry Extract from Northwestern Romania: A Retrospective Audit of 192 Records and Diagnosis Trends, 2013–2023

Background: Regional HIV data can support surveillance only when the meaning, timing, and completeness of core variables are explicit. We audited a regional HIV registry extract from Bihor County, Northwestern Romania, and described recorded diagnoses during 2013–2023. Methods: The supplied extract contained 192 individual records. Completeness analyses used all records. Annual-count analyses used 154 records with a diagnosis year between 2013 and 2023; 22 records diagnosed before 2013 and 16 with unknown diagnosis year were excluded from temporal analyses. A prespecified recorded advanced-category proxy was defined as CDC stage C and/or immunologic category 3 among records with interpretable A1–C3 staging. Drug indicators were recoded as non-mutually exclusive antiretroviral classes. A Poisson model quantified change in annual recorded counts; it was not interpreted as incidence because population denominators were unavailable. Results: Diagnosis year was available in 176/192 records (91.7%), residence in 149/192 (77.6%), interpretable CDC staging in 119/192 (62.0%), and at least one ART entry in 112/192 (58.3%). Exact diagnosis date, CD4 count, viral load, ART initiation date, retention in care, viral suppression, and transmission route were not represented as dedicated variables in the supplied extract. Annual recorded diagnoses ranged from 6 to 21. There was no evidence of a linear change in annual counts (incidence-rate ratio per year 0.972, 95% CI 0.925–1.022; p = 0.274). Among 119 staged records, 48 (40.3%) met the recorded advanced-category proxy; the timing of staging relative to diagnosis was unknown. NRTI exposure was the most frequently documented ART class, but treatment sequence and current-regimen status could not be reconstructed. Conclusions: The extract supports a data-quality and descriptive audit, not estimates of HIV incidence, confirmed late diagnosis, treatment effectiveness, or the HIV care continuum. Standardized capture of diagnosis date, CD4 count, viral load, staging date, ART initiation and current regimen, transmission route, and follow-up status is required for stronger regional surveillance.