Epidemiological characterization of individuals with newly reported HIV infection: South Carolina, 2004-2005.

Abstract

We used statewide data to assess HIV disease stage at initial diagnosis and laboratory indications for initiating antiretroviral therapy among South Carolina residents with newly diagnosed HIV infection. Initial CD4+ counts and viral loads among individuals diagnosed with HIV between May 2004 and April 2005 were categorized according to current staging and treatment guidelines. Of 759 individuals who had a CD4+ count reported, 34% and 56% had counts of 200 cells/mm(3) or below and 350 cells/mm(3) or below, respectively. CD4+ counts of 200 cells/mm(3) or below were significantly associated with male gender (adjusted odds ratio [AOR] = 2.07; 95% confidence interval [CI] = 1.36, 3.16), age above 29 years (AOR = 2.45; 95% CI = 1.51, 3.96), and hospital-reported patients (AOR = 2.17; 95% CI = 1.41, 3.36). The same characteristics were significant risk factors for elevated viral loads. At least in South Carolina, HIV diagnoses are delayed in a significant percentage of patients. New testing strategies need to be implemented to encourage earlier HIV diagnoses, and future studies should evaluate the effects of expanded routine testing on earlier detection.