Late HIV diagnoses (CD4 count <350 cells/mm3at diagnosis) across UK declined from 57% (2004) to 39% (2015) however a review within our region in 2013–14 revealed much higher proportion of late diagnoses than UK average, with multiple missed opportunities for testing in majority cases. Data was presented at educational meetings and feedback given to clinicians when delay in diagnosis occurred. We sought to assess impact on late diagnoses and mortality within our population.Methods
Retrospective chart analysis of new diagnoses from March 2015–February 2016 (Period 2) to determine proportion of late diagnosis, missed opportunities for testing and mortality. Comparison made with results of previous review during July 2013–June 2014 (Period 1).Results
76 new diagnoses during period 1; 71 in period 2. Late diagnosis decreased from 59% (45/76) to 49% (35/71). Proportion diagnosed through GUM increased from 20% to 34%. Remainder diagnosed in other specialities, most commonly general medicine. Mode of transmission in period 1 and 2 respectively; MSM 49% vs71%, heterosexual 47% vs 23%, IVDU 7% vs 11%. Prior to diagnosis, number patients presenting to other settings with clinical indicator diseases significantly decreased from 84% (38/45) in period 1 to 49% (17/35) period 2. Mortality more than halved from 7% (4/45) in period 1 to 3% (1/35) period 2.Discussion
While there has been a decrease in number of late diagnoses and mortality rate, the proportion being diagnosed late remains higher than other UK regions. Opportunities for early testing are still being missed and ongoing education required.