REVIEW ARTICLE
Infectious Diseases
doi: 10.25005/2074-0581-2025-27-4-952-965
FACTORS RELATED TO LATE HIV DIAGNOSIS IN ADULTS ACROSS EUROPE: A SYSTEMATIC REVIEW AND META-ANALYSIS

S.T. AGLIULLINA1, G.R. KHASANOVA1, D.V. NURLYGAYANOVA2, D.R. AGLIULLIN1

1Epidemiology and Evidence-Based Medicine Department of Kazan State Medical University, Kazan, Russian Federation
2Interregional Clinical and Diagnostic Center, Kazan, Russian Federation

Objective: To systematically review and meta-analyze studies on factors associated with HIV infection risk in Europe's adult population.

Methods: A literature search was conducted in both English and Russian using the electronic databases Scopus, PubMed, Google Scholar, and eLibrary. The analysis focused on articles published between 1991 and 2022. The selection criteria for the studies included in the meta-analysis were based on the current European definition of LD as a diagnosis of HIV infection with a CD4+ T cell count of less than 350 cells/mm³ and/or an AIDS-defining illness at the time of diagnosis, regardless of CD4+ cell count. When multiple studies from the same country were available, preference was given to those with the largest sample sizes. The random-effects model and the inverse-variance method were used to estimate the odds ratio (OR) and its 95% confidence interval (CI). Heterogeneity among the studies was assessed using the I² statistic.

Results: A total of 274 publications were identified, and 18 studies met the inclusion criteria. From these, nine studies published between 2011 and 2021 were selected for meta-analysis. The analysis involved data from 61,548 patients newly diagnosed with HIV, of whom 30,831 (50.1%) were identified as having LD of HIV. The prevalence of HIV infection associated with LD varied among European countries, ranging from 44.5% to 62.8%. The factors are related to LD of HIV infection included being over the age of 30 to 35 years (OR=2.05; 95% CI 1.85-2.27; I²=78%), female gender (OR=1.34; 95% CI 1.04-1.73; I²=96%), and heterosexual transmission (OR=1.72; 95% CI 1.40-2.11; I²=94%). In contrast, infection through intravenous drug use did not show a statistically significant association with LD (OR=1.11; 95% CI 0.73-1.70; I²=97%). However, homosexual transmission was associated with a timely diagnosis of HIV infection (OR=0.45; 95% CI 0.35-0.59; I²=97%).

Conclusion: LD of HIV infection is prevalent in European countries. There is a need for educational efforts to enhance motivation for HIV testing across all groups of the population, particularly those over 30-35 years of age and those engaged in heterosexual relationships.

Keywords: HIV infection, AIDS, late diagnosis, systematic review, Europe, risk factors, prevalence.

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Authors' information:

Agliullina Saida Takhirovna,
Candidate of Medical Sciences, Associate Professor of the Epidemiology and Evidence-Based Medicine Department, Kazan State Medical University
Researcher ID: KMY-2493-2024
Scopus ID: 57200421742
ORCID ID: 0000-0003-4733-6911
SPIN: 2079-1833
Author ID: 825346
E-mail: saida.agliullina@kazangmu.ru

Khasanova Gulshat Rashatovna,
Doctor of Medical Sciences, Full Professor, Head of the Epidemiology and Evidence-Based Medicine Department of Kazan State Medical University
Researcher ID: AAH-6849-2019
Scopus ID: 6507469219
ORCID ID: 0000-0002-1733-2576
SPIN: 6704-2840
Author ID: 465596
E-mail: gulshatra@mail.ru

Nurlygayanova Diana Vilnurovna,
Epidemiologist of Interregional Clinical and Diagnostic Center
ORCID ID: 0009-0008-3665-7350
E-mail: diana.khamitova.96@mail.ru

Agliullin Damir Rishatovich,
Candidate of Medical Sciences, Assistant of the Epidemiology and Evidence-Based Medicine Department, Kazan State Medical University
Scopus ID: 57216211079
ORCID ID: 0000-0001-7474-609Х
SPIN: 1356-0270
Author ID: 1038918 E-mail: agliullin.damir85@yandex.ru

Information about support in the form of grants, equipment, medications

This work was funded by a grant from the Academy of Sciences of the Republic of Tatarstan, Russia which supports young scientific candidates (postdoctoral students) in their pursuits of defending doctoral dissertations, conducting research, and fulfilling roles in scientific and educational organizations within the Republic of Tatarstan, Russia as part of the State Program "Scientific and Technological Development of the Republic of Tatarstan". The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Agliullina Saida Takhirovna
Candidate of Medical Sciences, Associate Professor of the Epidemiology and Evidence-Based Medicine Department, Kazan State Medical University

420012, Russian Federation, Kazan, Butlerov str., 49

Tel.: +7 (927) 2444212

E-mail: saida.agliullina@kazangmu.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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