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  • Open Access

Continuing burden of HIV late presenters in the North East of England 2009

  • 1,
  • 2,
  • 2,
  • 2,
  • 3 and
  • 1
Journal of the International AIDS Society201013 (Suppl 4) :P107

https://doi.org/10.1186/1758-2652-13-S4-P107

  • Published:

Keywords

  • Infectious Disease
  • Medical Record
  • Early Diagnosis
  • Clinical Indicator
  • Late Presentation

Purpose of the study

To determine whether the pattern of late presentation noted previously in 2007 and 2008 in all patients newly diagnosed with HIV in our regional unit [1] has decreased since the publication of The UK National HIV Testing Guidelines in 2008 [2].

Methods

A retrospective case-note audit was undertaken in the ID/GUM clinics for all patients who were newly diagnosed with HIV in 2009. Patients were characterised as late presenters if they presented with a CD4 count of less than 200 or an AIDS defining illness. Medical records were reviewed to determine whether the patients had previously been diagnosed with a clinical indicator disease as defined by the UK National HIV Testing Guidelines, 2008, which might have facilitated earlier diagnosis of HIV. These 2009 data were compared with previous 2007 and 2008 data.

Results

See table 1

Table 1

Source

ID 2009

GUM 2009

ID 2007

GUM 2007

ID 2008

GUM 2008

No of Patients

32

11

35

26

46

14

Late presenters

17 (53%)

3 (27%)

63%

59%

31%

21%

Male Gender

23 (72%)

11 (100%)

57%

54%

81%

89%

MSM

12 (38%)

10 (91%)

17%

54%

35%

79%

White British

19 (59%)

9 (82%)

37%

65%

54%

79%

Black African

11 (34%)

2 (18%)

49%

15%

43%

14%

Initial CD4 < 200 cells/µl

16*(52%)

3 (27%)

NK

NK

NK

NK

Symptomatic Seroconversion

3 (9%)

1 ((9%)

NK

NK

NK

NK

Previous Indicator Diseases

16 (50%)

1 (9%)

50%

50%

35%

29%

AIDS at/prior to diagnosis

8 (25%)

0(0%)

31%

0%

28%

0%

Commenced HAART

21 (66%)

6 (55%)

NK

NK

NK

NK

Conclusions

Significant numbers of patients (53% in ID; 27% in GUM) still present with advanced HIV disease in the North East of England in 2009 despite the publications of the National UK Testing Guidelines in 2008. The numbers of late presenters have not changed as compared to 2007 and 2008. This is despite that a large proportion having had previous indicator diseases that should have prompt clinicians to test for HIV. Further education and awareness of the UK National Testing Guidelines 2008 should be encouraged if this burden of late presenters is to be reduced.

Authors’ Affiliations

(1)
Royal Victoria Infirmary, Infection & Tropical Medicine, Newcastle upon Tyne, UK
(2)
University of Newcastle, Medical School, Newcastle upon tyne, UK
(3)
Newcroft Centre, GUM, Newcastle upon Tyne, UK

References

  1. Premchand N, Golds K, Tan P.Y, Sankar N, Ong E: The burden of late presentation:characteristics of patients newly diagnosed with HIV in the North East of England in 2007 and 2008. HIV Medicine. 2009, 10 (Suppl.2): PE18.11/1Google Scholar
  2. Palfreeman A, Fisher M, Ong E: Testing for HIV:concise guidance. Clinical Medicine. 2009, 9 (5): 471-6.View ArticlePubMedGoogle Scholar

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