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In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008. During that period, 11982 patients were under medical follow-up in Belgium. Sixty-one percent of the patients were male and the median age was 39.8 at the time of first recorded viral load. Among the patients whose nationality or probable mode of transmission was recorded, nearly half (48.0%) were Belgian and 38.3% originated from Sub-Saharan Africa; heterosexual contacts were reported in the majority of cases (56.0%) followed by homosexual contacts (35.3%). A total of 145 deaths were reported. Around three quarters of the patients were on ART. The median CD4 cell count rose from 470 cells/mm3 in 2006 to 501 cells/mm3 in 2008. This cohort enabled us to obtain comprehensive information on the numbers and characteristics of HIV-infected patients currently being followed up in Belgium, and on trends in antiretroviral therapy and biological results. This will serve for planning purposes, evaluation of access to care and as a source of information for further studies.

Objectives: Surveillance of sexually transmitted infections (STI) among HIV patients in AIDS Reference Centers aims at identifying risk groups and detecting specific STI emerging in this population., Methods: Seven of the nine AIDS Reference Centers in Belgium participate in this surveillance. The reported STI include Chlamydia, gonorrhea, syphilis, Lymphogranuloma venereum, hepatitis B virus and newly acquired hepatitis C in men who have sex with men (MSM)., Results: In 2008, 252 HIV patients (250 men, 2 women) were reported with a new STI episode. Sexual orientation was known for 245 men: 241 were MSM, 4 were heterosexual men. In total, 279 new STI episodes were reported. More than half of the diagnoses were syphilis. In 78% of the syphilis cases, the motive of the consultation was not related to an STI complaint., Conclusions: The results underline the importance of regular STI screening among HIV-positive persons, and show a particular sexual health problem among MSM. We estimate that the proportion of HIV-positive MSM acquiring an STI in 2008 was 8.8%.

Objectives In 2011, a consensus was reached defining 'late presenters' ( LPs) as individuals presenting for care with a CD4 count < 350 cells/μL or with an AIDS-defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account. Methods Case surveillance data for newly diagnosed patients in Belgium in 1998-2012 were analysed, including CD4 count at diagnosis, the presence of AIDS-defining events, and recent infections (< 6 months) as reported by clinicians in the case of acute illness or a recent negative test. First, proportions of LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as 'nonlate' if infections were reported as recent. Results A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men ( MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition ( P < 0.001). The proportion of patients misclassified as LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012. Conclusions This study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. [ABSTRACT FROM AUTHOR]