Late HIV presentation: epidemiology, clinical implications and management

Area of Science:

• Infectious Diseases
• Immunology
• Public Health

Background:

• Late presentation of Human Immunodeficiency Virus (HIV) is a significant clinical challenge.
• It is associated with adverse outcomes like faster disease progression, poorer immune recovery, and increased drug toxicity.
• Factors contributing to late diagnosis include lack of knowledge about HIV and treatment benefits, leading to poor adherence.

Purpose of the Study:

• To review definitions, risk factors, and consequences of late HIV presentation.
• To discuss optimal timing and agents for antiretroviral therapy (ART).
• To summarize strategies for increasing HIV testing uptake.

Main Methods:

• Literature review of definitions, risk factors, and outcomes of late HIV presentation.
• Evidence synthesis on ART initiation and drug selection.
• Review of vaccination and opportunistic infection prophylaxis guidelines.
• Summary of public health strategies for HIV testing.

Main Results:

• Late HIV presenters face increased risks of clinical progression and blunted immune recovery on ART.
• Adherence challenges are often linked to factors causing delayed diagnosis.
• Optimal ART strategies and prophylaxis are essential for managing late presenters.

Conclusions:

• Late HIV presentation necessitates comprehensive management strategies.
• Improving HIV testing uptake is critical to reduce the incidence of late diagnosis.
• Early diagnosis and timely treatment are key to better patient outcomes.