Evolution of HIV epidemic trends and diagnostic delays in French Guiana: how can we make further progress?

BMC Infectious Diseases

卷:26

Research

Mathieu Nacher^1,2,3,4  Aude Lucarelli⁴  Fanja Vergeade⁵  Sebastien Rabier⁴  Claudia Delin^4,6  Loïc Epelboin⁷  Céline Michaud⁸  Philippe Abboud⁷  Paul Le Turnier⁷  Myriam El Guedj⁹  Tania Vaz⁹  Hawa Cisse⁹  Félix Djossou⁷  Pierre Couppié^2,10  Antoine Adenis^1,2,3 

[1] Centres délocalisés de Prévention et de Soins, Centre hospitalier de Cayenne, 97300, Cayenne, French Guiana

[2] CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana

[3] Amazonian Center for Population Health, 97300, Cayenne, French Guiana

[4] COREVIH Guyane, Centre hospitalier de Cayenne, 97300, Cayenne, French Guiana

[5] Service des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, 97300, Cayenne, French Guiana

[6] Département Formation Recherche Santé, Université de Guyane, 97300, Cayenne, French Guiana

[7] Département de Santé Publique, Centre Hospitalier de l’Ouest Guyanais, 97320, Saint Laurent du Maroni, French Guiana

[8] Hopital de Jour Adultes, Centre hospitalier de Cayenne, 97300, Cayenne, French Guiana

[9] Centre Hospitalier de Kourou, 97304, Kourou, French Guiana

[10] Service de dermatologie vénéréologie, Centre hospitalier de Cayenne, 97300, Cayenne, French Guiana

关键词: HIV;    AIDS;    French Guiana;    Diagnostic delay;    Incidence;    Modelling;   

DOI  :  10.1186/s12879-026-12851-4

 received in 2024-09-26, accepted in 2026-02-06,  发布年份 2026

来源: Springer

【 摘 要 】

BackgroundAs antiretroviral treatment indications evolved, an increasing proportion of patients have been treated; since 2017, most patients receive antiretroviral treatment, irrespective of their CD4 count, in French Guiana and neighboring countries. In this context, we aimed to model the epidemic and to study the evolution of the estimates of the intervals between HIV-infection and HIV diagnosis in French Guiana.MethodsThe study was descriptive and comparative. Anonymous data from all persons in the DAT’AIDS HIV cohort based on quality-controlled clinical records was aggregated into yearly statistics between 2000 and 2023. We estimated year of infection using the rate of CD4 decline between the CD4 count at diagnosis and the estimation of the CD4 count at the time of HIV infection. The HIV modelling platform version 3.0.2 used the annual number of new HIV infections, the number of new AIDS cases, the number of new HIV infections that had AIDS, and CD4 strata to compute incidence, number of diagnosed and undiagnosed persons, and diagnostic delay.ResultsAll indicators improved markedly over time. Incidence declined, diagnostic delay declined, the proportion of undiagnosed patients declined, and deaths declined. However, the estimated interval between HIV infection and diagnosis was heterogenous between groups: It was about 2 years longer among males than among females, and it was about 3 years longer among Surinamese or Brazilian immigrants. Overall, 5% of all persons with HIV were undiagnosed, 9% of diagnosed persons were not on antiretroviral therapy and 6% of those on antiretroviral therapy were in virological failure. For a population of about 4,000 persons with HIV this represents a residual source of transmission.ConclusionsThe scaling up of testing, antiretroviral treatment, and preexposure prophylaxis has led to remarkable progress. Nevertheless, further shrinking the reservoir of undiagnosed infections and maximizing the proportion of successfully treated persons living with HIV is still likely to further improve control of the epidemic.Clinical trialThis is not a clinical trial.

【 授权许可】

CC BY-NC-ND   
© The Author(s) 2026

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Figure 4. Expression of MEK1-Nluc.

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