Clinical profile of patients with undiagnosed human immunodeficiency virus infection presenting to a local emergency department: a pilot study

X Wang, LP Leung
Accident and Emergency Department, Queen Mary Hospital, Pokfulam, Hong Kong

OBJECTIVES. To investigate the clinical profile of patients unaware of having human immunodeficiency virus (HIV) infection on presentation to the emergency department and provide a direction for future prospective studies on undiagnosed HIV infection in emergency department patients.

DESIGN. Retrospective, descriptive case series.

SETTING. A university teaching hospital in Hong Kong.

PATIENTS. Patients who were diagnosed for the first time with HIV infection or acquired immunodeficiency syndrome after presenting to the accident and emergency department from 2001 to 2011.

MAIN OUTCOME MEASURES. Demographic and clinical characteristics of the recruited patients.

RESULTS. Forty-four patients satisfied the inclusion criteria and were analysed. Most patients (36%) were 40 to 49 years old. Heterosexual practice was admitted by 73% of them. Fever (48%) was the commonest presenting symptom. Ten patients died during their index admission. There were no significant differences between those who died and survivors with regard to gender, age, triage category, and CD4 cell counts. Nor were there any significant differences in gender, age distribution, and sexual orientation in these patients compared with the sample used in surveillance studies by the Centre for Health Protection in Hong Kong.

CONCLUSION. Patients unaware of HIV infection are not commonly encountered in accident and emergency department settings. Targeted screening of males aged between 20 and 49 years may increase the yield of HIV testing in such settings.


Hong Kong Med J 2013;19:300-4
Epub 2013 Jun 21   |  DOI: 10.12809/hkmj133902

Key words: Delayed diagnosis; Emergency medical services; HIV infections; Population surveillance

 
 

 

The Hong Kong Medical Journal is a continuation of the former Journal of the Hong Kong Medical Association.
The Hong Kong Medical Journal is published by the Hong Kong Academy of Medicine and the Hong Kong Medical Association.
Copyright © 1995-2014 HKAM. All rights reserved.
URL: http://www.hkmj.org
Layout, design, and revisions Copyright © 2014 HKAM.
Revised 6 June 2014