United Kingdom, Ireland: Late HIV Diagnosis "A Problem"

A new study found that one-third of nearly 1,000 patients learned they had HIV only when their CD4 cell count was low. The study reported that 168 patients in the United Kingdom and Ireland had been to a hospital with HIV symptoms a year before being diagnosed. Late diagnosis, the study said, meant patients were missing out on drug therapy.

Investigators who surveyed more than 100 HIV centers in the United Kingdom and Ireland found that of 977 patients diagnosed with HIV, 301 had CD4 counts below the threshold for starting drug therapy. Black Africans and the elderly were more likely to have late diagnoses, they found.

Lead author Ann Sullivan said people at risk of HIV should be encouraged to be tested and that health care professionals need to be more proactive. "To improve this situation, the proportion of people diagnosed as having HIV as part of routine screening needs to increase, with people at risk being encouraged to have an HIV test," Sullivan wrote. "Health care professionals' awareness of factors associated with late presentation of HIV infection and conditions likely to be related to HIV also needs to increase."

Socioeconomic issues were cited by a spokesperson for the Terence Higgins Trust: "HIV is well understood by the gay community. HIV is stigmatized within the black African population, it is not really talked about. And when you think about the more disadvantaged groups and asylum seekers that may be having trouble with social care, housing or immigration, HIV may not be such a priority." A Department of Health spokesperson said attempts are underway to encourage early diagnosis.

The study, "Newly Diagnosed HIV Infections: Review in UK and Ireland" appeared in the British Medical Journal (2005; doi:10.1136/bmj.38398.590602.E0).

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