March 25, 2005
HIV-positive heterosexual men and women present for HIV testing at a later stage of infection than homosexual and bisexual testers, according to a prospective observational study by K. Manavi and colleagues, Lothian University Hospital National Health Service Trust. The authors defined late presentation as testing HIV-positive with a baseline CD4+ T-cell count less than 200 cells/mL.
Between December 1999 and January 2003, researchers compared baseline CD4+ T-cell counts in HIV-positive heterosexual men and women, IV drug users, homosexual and bisexual men diagnosed in Genitourinary Medicine and Regional Infectious Disease Unit (GUM/RIDU) departments, and routinely screened pregnant patients in Edinburgh.
During the study, 189 patients tested in GUM/RIDU and 13 screened pregnant females were diagnosed with HIV. Of them, 34 percent of GUM/RIDU patients and 38 percent of maternal patients had CD4+ T-cells of fewer than 200 cells/mL at diagnosis. Among the heterosexuals diagnosed at GUM/RIDU sites, 45 percent were late presenters. Significantly fewer homosexual men tested late. There was no difference in proportion of late testing between the antenatal diagnoses and all heterosexual GUM/RIDU diagnoses (5/13 and 35/78, respectively).
"A significant number of HIV-infected heterosexual patients are late presenters in the HIV testing at GUM/RIDU," researchers concluded. "HIV screening programs for heterosexual individuals in any medical encounter may reduce the number of late presenters."
The full study, "Heterosexual Men and Women With HIV Test Positive at a Later Stage of Infection Than Homo- or Bisexual Men," was published in International Journal of STDs and AIDS (2004;15(12):811-814).