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This study aims to assess the prevalence of late HIV diagnosis, to characterize individuals diagnosed at a late stage of infection and to evaluate regional differences in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, cross-sectional analysis included 1,169 individuals newly diagnosed with HIV in 2019 and 2020. Data on patient demographics, information on the HIV diagnosis and laboratory parameters were collected. Late diagnosis and advanced HIV disease were defined according to established consensus criteria. Regional comparison was made between eastern and western Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our cohort, 82.6% of the individuals were male and 16.9% female, with a median age of 39\u00a0years (IQR: 31\u201350). The prevalence of late diagnosis was 61.6% and advanced HIV disease, as a subgroup of late diagnosis, was present in 41.7%. Individuals with late diagnosis were significantly older than those diagnosed at an earlier stage (p &lt; 0.001). Patients in eastern Germany were diagnosed at more advanced stages of infection with significantly higher rates of late diagnosis (p &lt; 0.01), advanced HIV disease (p &lt; 0.001), and AIDS-defining conditions (p &lt; 0.001), as well as significantly lower CD4 cell counts (p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data demonstrate that a high proportion of HIV diagnoses in Germany are made at a late stage of infection. Late diagnosis was more frequent in older individuals and in those living in eastern Germany. These findings highlight the need for strengthened HIV testing strategies, particularly in underserved populations and regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02935-3","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:59:01Z","timestamp":1787644741000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of late HIV diagnosis in Germany in 2019 and 2020 - A regional analysis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9274-5911","authenticated-orcid":false,"given":"Carlotta","family":"Helbig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias W.","family":"Pletz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Ankert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Forthmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Bickel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Degen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Noe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Wesselmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Tominski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Holm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Spinner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neel","family":"Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Boesecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Baumgarten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Stocker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"L\u00fcbbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Heuchel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Wyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Obst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Ruck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"R\u00f6\u00dfler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heribert","family":"Knechten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Waizmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Seidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4678-2469","authenticated-orcid":false,"given":"Benjamin T.","family":"Schleenvoigt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HIV-regional study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"2935_CR1","doi-asserted-by":"publisher","unstructured":"An der Heiden M, Koppe U, Kollan C, Schmidt D, Gunsenheimer-Bartmeyer B, V B. 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Mathias W. Pletz has received funding (including indirect payments to the employer) for research projects, consulting fees, honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, travel support, and payment for participation on Data Safety Monitoring Boards or Advisory Boards from AstraZeneca, bioM\u00e9rieux, GlaxoSmithKline, Infectopharm, Janssen, Merck Sharp & Dohme (MSD), Moderna, Pfizer, Sanofi, Shionogi, and Tillotts. He holds a patent on bioactive glass element. He serves as President of the Paul-Ehrlich-Society, as member of the Board of Directors of CAPNETZ and the German Sepsis Society, as German delegate to the Surviving Sepsis Campaign, and on the steering board of national guidelines on community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), multidrug-resistant organisms (MDRO), sepsis, post-COVID, and phage therapy (all unpaid). None of the disclosed relationships are related to the present work. Christoph Stephan received honorarium fees from the following pharmaceutical companies for scientific lectures, presentations, manuscript writing, educational events, or participation in scientific advisory boards: Gilead Sciences, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme (MSD), Shionogi, Thera-Technologies, ViiV Healthcare. Furthermore, the pharmaceutical companies AbbVie, Gilead Sciences, and Janssen have covered for him travel, accommodation and registration fees for scientific conference participation. None of the disclosed relationships are related to the present work. Christoph Spinner has received funding (including indirect payments to the employer) for research projects, honoraria for consulting and\/or lectures, and\/or travel support from AbbVie, Apeiron, AstraZeneca, Bavarian Nordic, B. Braun Melsungen, BioNTech, Cepheid, CSL Seqirus, Eli Lilly, Formycon, Gilead Sciences, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme (MSD), Moderna, Molecular Partners, Pfizer, Roche, Shionogi, Synairgen, Swedish Orphan Biovitrum, and ViiV Healthcare. None of the disclosed relationships are related to the present work. Neel Petersen has received consulting fees, speaking frees, travel expenses and conference fees from ViiV Healthcare and Gilead Sciences outside of this present work. Axel Baumgarten has received honoraria for consulting or speaking at educational events from Gilead Sciences, AbbVie, MSD, ViiV Healthcare, GlaxoSmithKline, Pfizer, AstraZeneca. None of the disclosed relationships are related to the present work. Christoph L\u00fcbbert received a speaker honorarium from Gilead Sciences outside of this present work. Christoph Wyen declares payment or honoraria for lectures, presentations or educational events from AbbVie, Gilead Sciences, ViiV Healthcare, Pfizer and Merck Sharp & Dohme (MSD) outside of this present work. Benjamin T. Schleenvoigt received financial support from the Central German Working Group HIV e.V. for the present study (indirect payment to the employer). He received fees and financial support from Gilead Sciences, Merck Sharp & Dohme (MSD), Janssen-Cilag, Pfizer, CRM, Falk, AstraZeneca, ViiV Healthcare, AIDS help Potsdam, AIDS help Dresden, Merck, BavarianNordic and Takeda outside of this present work.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was waived by the ethics committee of the University Hospital Jena (reference number: 4535\u201308\/17).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}