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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.104323v1 99/S1/S111    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ogbuanu, I. U. Articles by Duffus, W. A. Search for Related Content PubMed PubMed Citation Articles by Ogbuanu, I. U. Articles by Duffus, W. A. Related Collections Epidemiology HIV/AIDS Public Health Practice Other Statistics/Evaluation/Research

Ikechukwu U. Ogbuanu, MBBS, MPH, Myriam E. Torres, PhD, MSPH, Lynda Kettinger, MPH, Helmut Albrecht, MD and Wayne A. Duffus, MD, PhD

At the time of the study, Ikechukwu U. Ogbuanu was with the Department of Health Services, Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, and the South Carolina Department of Health and Environmental Control, Columbia. Myriam E. Torres is with the Epidemiology and Biostatistics Department, Arnold School of Public Health, University of South Carolina, Columbia. Lynda Kettinger is with the STD/HIV Division, South Carolina Department of Health and Environmental Control, Columbia. Helmut Albrecht is with the Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia. Wayne A. Duffus is with the South Carolina Department of Health and Environmental Control, Columbia, and the Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia.

Correspondence: Requests for reprints should be sent to Wayne A. Duffus, MD, PhD, HIV/STD Division, South Carolina Department of Health and Environmental Control, 1751 Calhoun St, Columbia, SC 29201 (e-mail: duffuswa{at}dhec.sc.gov).

Objectives. 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.

Methods. 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.

Results. Of 759 individuals who had a CD4+ count reported, 34% and 56% had counts of 200 cells/mm³ or below and 350 cells/mm³ or below, respectively. CD4+ counts of 200 cells/mm³ 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.

Conclusions. 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.