Expert consensus on the clinical management of HIV late presentation

With the advancement of combination antiretroviral therapy (cART), the global number of new human immunodeficiency virus (HIV) infections and HIV-related mortality has significantly declined. However, the high proportion of "late presentation" (defined as presenting to care with a low CD4 cell count or AIDS-defining events) among HIV-infected individuals remains a significant challenge in HIV prevention and treatment. HIV late presentation is associated with increased clinical risk, complex management, and higher risk of transmission, and represents a significant barrier to achieving the "95-95-95" targets and ending the HIV epidemic. Currently, both nationally and internationally, there is a lack of specific clinical guidelines for this population. Therefore, the China Association for Promotion of Health Science and Technology convened experts in the field to discuss the definition, clinical characteristics, risks, and cART of late presenters based on the latest research evidence and clinical practices both domestically and internationally. Specific recommendations were formulated to guide healthcare professionals in their clinical practice.