Diagnostic delay of infection with Human Immunodeficiency Virus

Retraso diagnóstico de la infección por el Virus de Inmunodeficiencia Humana

Objective. To analyze the behavior of the diagnostic opportunity by evaluating Diagnostic Delays (RD) and diagnoses with Advanced Stage Presentation (PEA) in HIV / AIDS cases. Materials and methods. Retrospective descriptive study of diagnoses of infection by the HIV virus in health care institutions. New cases or incidents diagnosed between January 1, 2011 and December 31, 2016 were included. Diagnostic delay (RD) was labeled as those that obtained CD4 less than 350, Presentation with Advanced Disease (PEA) by CD4 less than 200, and an additional category of CD4 less than 500 used as reference standard. Results. 188 incidents were entered all with results of CD4 lymphocyte count; the median age was 30 (Interquartile range 23-40), median CD4 of 230. Regarding the interpretation of the delays 43.6% of the cases presented PEA, 68.6% classified for RD. The proportion of RD and PEA was higher among men and in the older age groups; according to the mode of transmission, sexuality predominated, with the RD and PEA being more frequent among Men who have Sex with Men (MSM), in contrast to what has been observed in other studies, a situation that denotes difficulties in targeting subjects at risk. Conclusion. The cases that are being diagnosed in the final phase correspond to older individuals, male with a history of MSM practices; the findings allow to identify factors that influence the lack of opportunity for diagnosis, failures in public health management in relation to the prevention and control of HIV in key populations.