title: HIV - lessons from a late diagnosis.
abstract: Late HIV diagnosis is the most important predictor of HIV-related morbidity and mortality in the UK and often results from missed testing opportunities during earlier contact with health services. The HPA now recommends routine HIV testing be commissioned as a priority for all general medical admissions in high prevalence areas, such as Milton Keynes. We present the case of a patient admitted to our Medical Admissions Unit (MAU) managed initially for presumed septic complications of metastatic disease who was later found to have terminal HIV disease. In keeping with UK-wide experience which we review, a local audit following this case found MAU HIV test coverage increased after routine testing but not after staff education alone, and resulted in implementation of routine HIV testing in our MAU.
authors.affiliation: MSc, MRCP, DTM&H, Oxford University Hospitals.
authors.forename: Xin Hui S
authors.initials: XH
authors.lastname: Chan
authors.affiliation: MBBS, Oxford University Hospitals.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Onen
authors.affiliation: FRCP, FRCPath, Milton Keynes University Hospital.
authors.forename: Mansoor M
authors.initials: MM
authors.lastname: Raza
authors.affiliation: FRCP, Dip GUM, DFFP, Milton Keynes University Hospital.
authors.forename: Dushyant
authors.initials: D
authors.lastname: Mital
authors.affiliation: FRCP, Milton Keynes Hospital, Standing Way, Eaglestone, Milton Keynes, MK6 5LD, UK.
authors.forename: R William
authors.initials: RW
authors.lastname: Smith
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis / Q000517:prevention & control*; D003937:Diagnosis, Differential; D003955:Diagnostic Tests, Routine / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D010343:Patient Admission / Q000592:standards*; D015995:Prevalence; D012698:Serologic Tests / Q000379:methods; D006113:United Kingdom / Q000453:epidemiology