Newly diagnosed HIV infections: review in UK and Ireland

In 2001, 59% of people in the United Kingdom with HIV who were starting treatment had CD4 lymphocyte counts of fewer than 200 cells/ l, 1 mostly because of late diagnosis.We investigated new HIV diagnoses in the UK and Ireland, to assess the occurrence of late diagnosis (CD4 lymphocyte count < 200cells/ l) and associated features and to determine if patients had prior presentations that may have been related to HIV infection. Participants, methods, and resultsWe did a national case review by sending structured questionnaire forms to adult HIV care providers in the United Kingdom and Ireland for patients presenting with a new diagnosis of HIV infection in January-March 2003 (maximum of 25 per centre).We collected information on clinical and immune status and hospital admissions and symptoms or conditions in the previous 12 months that might have been HIV related.Of 148 centres, 113 (76%) responded with data on 977 patients.Overall, 301 (33%) presented late (table), and this was more common in older patients (adjusted odds ratio per increase in age group 1.68, 95% confidence interval 1.42 to 1.98; P = 0.0001) and in black Africans (1.66, 1.05 to 2.62, P = 0.03), but less likely in homosexual men, independent of age and ethnicity (0.63, 0.38 to 1.05, P = 0.07).Overall, 401 (41%) were diagnosed via routine screening; this was