title: Late presentation of HIV infection: a consensus definition.
abstract: OBJECTIVE
  Across Europe, almost a third of individuals infected with HIV do not enter health care until late in the course of their infection. Surveillance to identify the extent to which late presentation occurs remains inadequate across Europe and is further complicated by the lack of a common clinical definition of late presentation. The objective of this article is to present a consensus definition of late presentation of HIV infection.
  
  
  METHODS
  Over the past year, two initiatives have moved towards a harmonized definition. In spring 2009, they joined efforts to identify a common definition of what is meant by a 'late-presenting' patient.
  
  
  RESULTS
  Two definitions were agreed upon, as follows. Late presentation: persons presenting for care with a CD4 count below 350 cells/μL or presenting with an AIDS-defining event, regardless of the CD4 cell count. Presentation with advanced HIV disease: persons presenting for care with a CD4 count below 200 cells/μL or presenting with an AIDS-defining event, regardless of the CD4 cell count.
  
  
  CONCLUSIONS
  The European Late Presenter Consensus working group believe it would be beneficial if all national health agencies, institutions, and researchers were able to implement this definition (either on its own or alongside their own preferred definition) when reporting surveillance or research data relating to late presentation of HIV infection.
authors.affiliation: National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.forename: T
authors.initials: T
authors.lastname: Coenen
authors.forename: D
authors.initials: D
authors.lastname: Costagiola
authors.forename: N
authors.initials: N
authors.lastname: Dedes
authors.forename: M
authors.initials: M
authors.lastname: Ellefson
authors.forename: J
authors.initials: J
authors.lastname: Gatell
authors.forename: E
authors.initials: E
authors.lastname: Girardi
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: O
authors.initials: O
authors.lastname: Kirk
authors.forename: J
authors.initials: J
authors.lastname: Lundgren
authors.forename: A
authors.initials: A
authors.lastname: Mocroft
authors.forename: A
authors.initials: A
authors.lastname: D'Arminio Monforte
authors.forename: A
authors.initials: A
authors.lastname: Phillips
authors.forename: D
authors.initials: D
authors.lastname: Raben
authors.forename: J K
authors.initials: JK
authors.lastname: Rockstroh
authors.forename: C
authors.initials: C
authors.lastname: Sabin
authors.forename: A
authors.initials: A
authors.lastname: Sönnerborg
authors.forename: F
authors.initials: F
authors.lastname: De Wolf
mesh_terms: D018791:CD4 Lymphocyte Count; D032921:Consensus; D057210:Delayed Diagnosis / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D006291:Health Policy; D006801:Humans; D010342:Patient Acceptance of Health Care; D013997:Time Factors