BMJ  2008;336:1451-1452 (28 June), doi:10.1136/bmj.39619.626782.3A

Letters

Missed opportunities

Undiagnosed HIV infection in patients with viral hepatitis

The first 150 words of the full text of this article appear below.

A third of HIV infected people in the UK are unaware of their infection.1 Many repeatedly access medical care but are not diagnosed until much later in their disease course.1 2 The chief medical officer recently called on doctors to improve recognition of undiagnosed HIV infection nationwide. One strategy is the adoption of routine opt-out HIV testing in settings where undiagnosed people may present.3 While patients’ acceptance may not be an important barrier,4 uncertainties remain about the benefit of widespread routine testing, partly based on the assumption that clinical judgment can identify patients at risk of infection. To inform HIV testing strategies, data on the likely yield from changed testing policies are required.3 We show here that half of HIV infected patients attending a viral hepatitis referral unit that follows a clinician directed testing policy remain undiagnosed.

With ethics committee approval, we conducted a retrospective, anonymous HIV seroprevalence study among 268 . . . [Full text of this article]

Anna Maria Geretti, consultant in virology, Sara Madge, associate specialist in HIV medicine, Marcus Posner, medical student, Geoff Dusheiko, professor of hepatology, Michael Jacobs, senior lecturer in infectious diseases

1 Royal Free Hospital and Royal Free and University College Medical School, London NW3 2QG

a.geretti@medsch.ucl.ac.uk


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