It is an observation “dramatically persistent” which prepares HIV specialists in France. In about a third of patients, in fact, the diagnosis is too late and treatment begins at an already advanced stage of the infection. A situation that has not improved since the early 2000s. and this, “Despite screening and access to care policies deployed”Underlines Sophie Grabar, public health doctor at Inserm and Saint-Antoine Hospital (AP-HP, Sorbonne University, Paris).
This is shown by the results presented at a press conference on Thursday 14 March by the National Agency for Research on AIDS and Viral Hepatitis – Emerging Infectious Diseases (ANRS MIE). Some time ago, this data was announced during the conference on retroviruses and opportunistic infections held in Denver (United States) from March 3 to 6.
Between 2002 and 2016, 64,400 people living with HIV in French hospitals (except Nouvelle-Aquitaine, where patients are followed separately) were included within the cohort established by ANRS MIE.. “This group brings together about 68% of all patients treated on the French territory”, mentions Sophie Graeber, who coordinates the monitoring. Its advantage: it makes it possible to measure the effect of care on mortality.
Significant impact on mortality
Results are improving. Among the patients in this group, only 51% reached the hospital at the initial stage of infection: their CD4 cell count (soldiers of the immune system that is the main target of HIV) was greater than or equal to 350 cells per cubic millimeter. blood; 20% reached an intermediate stage of infection, with a CD4 count between 200 and 350.
Even more severe, 28.4% of patients presented to the hospital with advanced disease. Of these, 19.5% had a CD4 count below 200 cells per cubic millimeter; And 8.9% also declared AIDS, which is characterized by the presence of at least one “opportunistic” disease associated with the virus (tuberculosis, Kaposi’s sarcoma, malignant non-Hodgkin’s lymphoma, etc.).
Another distressing observation: between the 2002-2013 and 2014-2016 periods, the proportion of people receiving care too late improved little or nothing, from 28.8% to 26.5%. A recent study, covering the Nouvelle-Aquitaine region, supports this observation. “In 2021, 30% of patients living with HIV remain in advanced stage care”Sophie Grabar mourns.
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