FACTEURS ASSOCIES AU DIAGNOSTIC TARDIF CHEZ LES PERSONNES VIVANT AVEC LE VIH (PVVIH) SUIVIES AU CHU DE NANTES

Abstract : In 2010, the number of people who were unaware of their HIV status in France was 30,000. People who are diagnosed late can not benefit from the full benefits of antiretroviral treatment and promote the spread of the epidemic. The objective of this study was to improve the identification of risk factors associated with the late diagnosis of people living with HIV followed at the University Hospital of Nantes, using in addition to the classical method of logistic regression, two methods alternative statistics: multilevel analysis and quantile regression. This study included 1179 people living with HIV followed at Nantes University Hospital Center and diagnosed between 2000 and 2014. Individual and contextual communal variables (level of urbanization, socio-economic level, accessibility to general practitioners) were simultaneously taken into account in the multilevel analysis (late diagnosis if <350 CD4 / mm³). Variation in the distribution of CD4 count at the diagnosis according to the explanatory variables was studied every 5 percentiles of CD4 for quantile regression. In the multilevel analysis, the factors associated with late diagnosis were quasi-rural / quasi-urban residence (aOR = 1.69, CI 95% : [1.13-2.52]), birth in a country the non-sexual mode of transmission, high age, occupational inactivity, being in a couple and the period of diagnosis between 2000 and 2003. With the quantile regression, the male sex, the heterosexual mode of transmission and the co- HBV and HCV infection were also negatively associated with CD4 levels only at certain quantiles. The impact of these variables on the different quantiles oscillated between 30 and 200 CD4. The results of this study suggest that HIV testing should be developed in urban peripheries and large isolated cities as well as targeted in certain populations said to be at low risk of infection (age> 30, heterosexual, couple) but also among migrants.
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L Bruneau. FACTEURS ASSOCIES AU DIAGNOSTIC TARDIF CHEZ LES PERSONNES VIVANT AVEC LE VIH (PVVIH) SUIVIES AU CHU DE NANTES. Santé publique et épidémiologie. Université de Nantes, Faculté de Médecine, 2015. Français. ⟨tel-02156541⟩

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