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Late Diagnosis of HIV
Oct 24, 2008

My younger brother recently was diagnosed with HIV and his CD4 counts are below 100. But what boggles my mind is the fact that my brother has LIVED in the hospital growing up his whole life due to a complicated chronic heart disease he was born with and growin up he was always sick. He was hospitalized SEVERAL times during his life time.. sometime for long lenghts of time. He's been suffering chronic sinusitis for over a year too and has been going to the hospital once every 2-3 weeks for the past year. YET what I don't understand is .. how could the doctors and hospital not detect or even predict that maybe all his problems were in fact because he was HIV positive this whole time? What requires a doctor or hospital to determine to do a test or suggest a patient to get a HIV test? Within the past year my brother was went to the ER 5 times and got all kinds of blood drawn out plus he is a coumadin patient so he gets regular blood drawn. I don't understand how this could have been detected so late when his CD4 counts are so low. What are the specifications in when a doctor needs to check for HIV or realize a patient's symptoms may be due to HIV? Please let me know. Thank yoU!

Response from Dr. Young

Thanks for your post.

I've sorry to learn about your brother.

His diagnosis with advanced HIV speaks to many issues. First is that many, many medical professionals are reluctant to test for HIV as part of routine health screening. As such, the opportunity for early diagnosis and treatment is missed. Part of this is the misbelief that we can somehow know who's at risk and who's not-- clearly incorrect. Further, doctors and nurses are afraid to bring up the diagnosis because of the want not the imply that a patient might be part of "that" high-risk group.

Since 2006, the CDC (and I) endorse the idea of HIV testing as part of routine healthcare screening (like that of cholesterol, for example). The revised screening recommendations can be read here.

Best of health to you and your brother.


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