{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:25:24Z","timestamp":1781850324932,"version":"3.54.5"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Late diagnosis of HIV remains a critical barrier to effective treatment and improved long-term outcomes. Individuals presenting with low CD4+ T cell counts at diagnosis are at greater risk for opportunistic infections, hospitalization, and mortality. This study aimed to compare clinical, immunological, and virological outcomes among early and late presenters, and to identify factors associated with virologic failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of 200 patients newly diagnosed with HIV between 2012 and 2019. Participants were categorized into three diagnostic groups based on baseline CD4+ T cell counts: early diagnosis (&gt;350 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ), late diagnosis 1 (200-350 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ), and late diagnosis 2 (&lt;200 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ). Baseline demographics, laboratory markers, clinical outcomes, and treatment responses were compared. Logistic regression was used to evaluate predictors of virologic failure at 6 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Late presenters accounted for 71% of the cohort and were more likely to be older, female, unmarried, and have lower education levels. They exhibited significantly lower CD4+ counts, CD4\/CD8 ratios, and higher HIV RNA levels at diagnosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Opportunistic infections, hospitalization, and mortality were significantly more common in the late diagnosis 2 group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Although virologic suppression was achieved in most patients, immune recovery was significantly impaired in those diagnosed late. Antiretroviral therapy (ART) initiation after 2015 was independently associated with lower risk of virologic failure (OR: 0.39;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Late HIV diagnosis is associated with increased clinical morbidity and impaired immune reconstitution, even in virologically suppressed individuals. Early detection, prompt ART initiation, and routine CD4\/CD8 monitoring are essential to optimize outcomes. Public health interventions targeting social determinants may help reduce delays in diagnosis and improve equity in HIV care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582251404545","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T14:35:11Z","timestamp":1764858911000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Late HIV Diagnosis and Its Impact on Immune Recovery and Clinical Outcomes: A Retrospective Study From Turkey"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2105-8004","authenticated-orcid":false,"given":"Nadide","family":"Erg\u00fcn","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, \rUniversity of Health Sciences, Izmir City Hospital, Izmir, \rT\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-7066","authenticated-orcid":false,"given":"G\u00fcrsel","family":"Ersan","sequence":"additional","affiliation":[{"name":"University of Health Sciences, Tepecik Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Global HIV & AIDS statistics\u2014Fact sheet","author":"UNAIDS","year":"2023","unstructured":"UNAIDS. Global HIV & AIDS statistics\u2014Fact sheet. Joint United Nations Programme on HIV\/AIDS; 2023. https:\/\/www.unaids.org."},{"key":"e_1_3_3_3_2","volume-title":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: Recommendations for a public health approach","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: Recommendations for a public health approach. WHO; 2021."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.21101\/cejph.a5416"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v18i1.694"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011453"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6792"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1241-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1004078"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-042909-093756"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001510"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031078"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2174\/157016209787581535"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2025.101243"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000243"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw085"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1413-8670(10)70115-x"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2023.104773"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(15)00006-5"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2016.09.004"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw076"},{"key":"e_1_3_3_22_2","volume-title":"Consolidated guidelines on HIV testing services","author":"World Health Organization","year":"2019","unstructured":"World Health Organization. Consolidated guidelines on HIV testing services. WHO; 2019."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12888"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.18356\/9789210019798"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582251404545","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582251404545","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582251404545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:50:49Z","timestamp":1777503049000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582251404545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":23,"alternative-id":["10.1177\/23259582251404545"],"URL":"https:\/\/doi.org\/10.1177\/23259582251404545","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"23259582251404545"}}