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9th Annual Conference Of The British HIV Association [BHIVA]24 – 26 April 2003, University of Manchester
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[AUTHOR(S):] L Adejolu, S Ash and W Lynn
Ealing Hospital, London, UK
BHIVA Conf 2003 Apr 24-26;9:O26
BACKGROUND: Early diagnosis and intervention is important to reduce the morbidity and mortality of HIV infection and BHIVA guidelines recommend that antiretroviral therapy is initiated before the CD4 count falls below 200 cells/µl. Patients with symptomatic HIV may present to a variety of clinical services providing a diagnostic opportunity. We performed an audit to identify whether such opportunities may be missed and to determine clinical outcome where delay has occurred.
METHODS: Retrospective review of 50 new HIV diagnoses in 2002. Data included CD4 count at diagnosis, previous medical care, time from first HIV-related symptoms to diagnosis and clinical outcome.
RESULTS: 31/50 patients presented with symptomatic disease with the other 19 being tested as part of antenatal or genitourinary medicine clinic screening. Of these symptomatic patients, 16/31 had a CD4 count of <50 cells/µl and 29/31 had <200 cells/µl. In contrast, of those detected through screening only, 4/19 had a CD4 count <200. 12 (24%) patients had previously presented to a variety of clinical services at different hospitals or primary care with symptoms suggestive of HIV. In six cases, the potential diagnostic delay exceeded 12 months. Five of these 12 patients presented with serious opportunistic infections requiring prolonged hospitalisation, two suffered permanent neurological damage and one died.
CONCLUSIONS: Clinicians still fail to recognise HIV-related symptoms, resulting in unnecessary morbidity and mortality. There is a continuing need to raise HIV awareness, particularly in areas of high local prevalence.
PRESENTING AUTHOR: L Adejolu
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Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD