Late presentation for HIV care across Europe: Update from the collaboration of observational HIV epidemiological research europe (COHERE) study, 2010 to 2013

Amanda Mocroft, Jens Lundgren, Antonella D’Arminio Monforte, Johanna Brännström, Fabrice Bonnet, Hansjakob Furrer, Corinne Jadand, Anne Johnson, Mario Lazanas, Santiago Moreno, Christina Mussini, Frank Post, Adriane Skaletz-Rorowski, Ignacio Suarez-Loano, Genevieve Chene, Robert Zangerle, Giota Touloumi, Josiane Warszawski, Laurence Meyer, Dabis François DabisMurielle Mary Krause, Jade Ghosn, Catherine Leport, Linda Wittkop, Peter Reiss, Ferdinand Wit, Maria Prins, Heiner Bucher, Diana Gibb, Gerd Fätkenheuer, Julia Del Amo, Niels Obel, Claire Thorne, Ole Kirk, Christoph Stephan, Santiago Pérez-Hoyos, Osamah Hamouda, Barbara Bartmeyer, Nikoloz Chkhartishvili, Antoni Noguera-Julian, Andrea Antinori, Antonella D’Arminio Monforte, Norbert Brockmeyer, Luis Prieto, Pablo Rojo Conejo, Antoni Soriano-Arandes, Manuel Battegay, Roger Kouyos, Cristina Mussini, Pat Tookey, Jordi Casabona, Jose M. Miró, Antonella Castagna, Deborah Konopnick, Tessa Goetghebuer, Anders Sönnerborg, Caroline Sabin, Ramon Teira, Myriam Garrido, David Haerry, Carlo Torti, Stéphane De Wit, Dominique Costagliola, Antonella D’Arminio-Monforte, Dorthe Raben, Geneviève Chêne, Diana Barger, Christine Schwimmer, Monique Termote, R. C C Copenhagen, Maria Campbell, Casper M. Frederiksen, Nina Friis-Moller, Jesper Kjaer, Rikke Salbøl Brandt, Juan Berenguer, Julia Bohlius, Vincent Bouteloup, Alessandro Cozzi-Lepri, François Dabis, Mary Anne Davies, Maria Dorrucci, David Dunn, Matthias Egger, Marguerite Guiguet, Sophie Grabar, Ali Judd, Olivier Lambotte, Valériane Leroy, Sara Lodi, Sophie Matheron, Susana Monge, Fumiyo Nakagawa, Roger Paredes, Andrew Phillips, Massimo Puoti, Michael Schomaker, Colette Smit, Jonathan Sterne, Rodolphe Thiebaut, Marc Van Der Valk, Natasha Wyss

Research output: Contribution to journalArticlepeer-review


Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrolment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm3 or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm3 (interquartile range (IQR) 193-555/mm3), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.

Original languageEnglish
Article number30070
Issue number47
Publication statusPublished - Nov 26 2015

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Virology


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