GHT Homepage News Doctors Often Miss HIV Clues

Doctors Often Miss HIV Clues
23rd Jul 2008

Sore throat, fever and a rash? Go and get it checked out, and make sure the checks done include an HIV test

HIV is spreading further because doctors overlook symptoms which reveal the infection, National Aids Trust reports.

The National Aids Trust say as many as half of all early-stage infections, often marked by severe flu-like symptoms, are being missed.

Spotting them and carrying out an HIV test would prevent further infections, it said.

A GP specialising in sexual health said doctors should always be open-minded to the possibility their patients had HIV.

Doctors need to always be alive to the possibility that the person in front of them may have HIV
Dr Christian Jessen GP

Newly-infected are the source of half the new HIV cases
There are approximately 7,000 new HIV infections in the UK every year, and as many as 50% are estimated to be passed on by people who are in the early stages of their own infection.

symptoms alert
In the first few weeks after infection, there are massive levels of the virus in the blood, and in most cases, this causes symptoms such as sore throats, fever and rashes. A person with HIV is at their most infectious at this point.

However, after six weeks, these symptoms generally fade and the infected person will feel back to normal, but will have HIV.

However, the National Aids Trust (NAT) said that people visiting a doctor, either their GP or in A&E, complaining of these symptoms were often told it was a trivial viral infection, or perhaps glandular fever, and to return if it did not improve in a couple of weeks.

Symptoms Watch
Symptoms of early-stage HIV are most frequently sore throat, fever and rash occurring at the same time, usually within 2 to 6 weeks of infection. Whilst taken separately these are common complaints, together this triad of symptoms, coupled with recent sexually risky behaviour should always suggest possible HIV and require a HIV test. These triplex of symptoms are an unusual combination for normally healthy people in their twenties and thirties.

A study in Brighton found that 48% of HIV patients had sought medical advice with their early symptoms but had still not been diagnosed.

Deborah Jack, the chief executive of NAT, said: "It is very worrying that GPs and other healthcare professionals are often missing the signs and symptoms of HIV infection.

"This can mean they become seriously ill in the longer term and respond less well to treatment.

"It also means they are likely to be putting partners at risk of infection as they may live undiagnosed for a number of years."

Dr Martin Fisher, a consultant in HIV medicine, said that this brief period was a "golden opportunity" to spot new cases.

He said: "HIV testing needs to be more widespread and routine. It's reasonable to expect doctors to be able to make this diagnosis."

Dr Christian Jessen, a GP specialising in sexual health medicine, said that doctors were still guilty of being influenced by the stereotypical notion of the "gay man with HIV".

"I have seen so many cases come to me which have been missed, and people with HIV are not just gay men, they are heterosexual men and women as well.

"Doctors need to always be alive to the possibility that the person in front of them may have HIV."

Lisa Power, of the HIV charity Terrence Higgins Trust, said it was important that those at particular risk of HIV, and those who provide healthcare, know the signs of such early HIV infection.

"Sore throat, fever and a rash? Go and get it checked out, and make sure the check includes an HIV test."

An Expert Seminar in which George House Trust contributed, took place in Spring. The Report Primary HIV Infection with about a dozen policy recommendations for the UK is now available here:
http://www.nat.org.uk/document/449

source
http://news.bbc.co.uk/1/hi/health/7518175.stm