The Health Protection Agency reports that a third of adults diagnosed with HIV in the UK last year were diagnosed late.
In 2008 there were 7,298 new diagnoses of HIV in the UK with an estimated 32% (2,310) of adults over 15 years being diagnosed at a point after which treatment should already have begun (CD4 cell count <200 per mm3). This results in patients missing out on the benefits that come from early diagnosis, including improved life expectancy.According to British HIV Association guidelines introduced last year, patients with HIV should now be considered for treatment when their CD4 cell count reaches <350 per mm3 rather than waiting until it falls further to <200 per mm3. If these guidelines were used when interpreting the latest figures, it would mean more than half (55%) of all individuals diagnosed last year would have been diagnosed late. The number of deaths among HIV-infected people has remained stable over the past decade. However, three quarters of the 525 people with HIV who died in 2008 had been diagnosed at a point after which treatment should have begun according to the latest treatment guidelines (a CD4 cell count <350 per mm3). This highlights the importance of promoting testing to ensure early diagnosis and enable successful treatment. The agency's annual HIV report also shows that the number of people living with HIV in the UK increased to 83,000 in 2008. This number will continue to rise as people with HIV live longer on effective therapy. Improvements have been made in the number of people testing for HIV - 100,000 more tests were performed at GUM (genitor-urinary medicine) clinics in 2008 than the previous year (950,000 up from 850,000 in 2007). 93% of people attending GUM clinics are now tested for HIV. This has continued to increase steadily since 2004 when 23% of visitors to a GUM clinic were not being tested for the infection. National HIV testing guidelines recommend wider HIV testing in those areas of the country where the prevalence of diagnosed HIV infection is greater than 2 per 1,000 population aged 15 to 59 years. There are 43 local authorities in England (35 Primary Care Trusts) where the prevalence of HIV is above this threshold. It is in these areas that health professionals should routinely offer HIV testing to all men and women aged 15 to 59 years who are registering in general practice or admitted for medical care. Dr Valerie Delpech, an expert in HIV from the Health Protection Agency said: 'HIV is a serious infection but if diagnosed early, there are very good treatment options. Of concern is that over 22,000 people remain unaware of their infection in the UK and cannot therefore benefit from effective treatment. 'It is encouraging to see the increased numbers of HIV tests being performed in STI clinics. However, we must reduce the number of people presenting late with their infection by increasing awareness of the importance of testing, improving access and de-stigmatising the HIV test. 'We need to continually reinforce the safe sex message - using a condom with all new or casual sexual partners is the surest way to ensure you do not become infected with a serious sexually transmitted infection such as HIV. 'People need to know that testing for HIV and all sexually transmitted infections is both free and confidential at sexual health clinics across the UK. If you have had unprotected sex with a new or casual partner you should go and get tested. 'Medical guidelines published last year have encouraged more widespread testing in areas where there is a high prevalence of diagnosed HIV and we hope this will contribute to improving awareness of the infection in this community and therefore increase testing.' |
