{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:16:30Z","timestamp":1791335790065,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of the study was to describe the characteristics of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected late presenters, opportunistic diseases at diagnosis and missed opportunities to diagnose <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection earlier.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective cohort study, we reviewed the medical records of all adults with newly diagnosed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection admitted to the Department of Infectious Diseases of the Vivantes Auguste\u2010Viktoria Hospital, Berlin, Germany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the 5\u2010year period from 2009 to 2013, 270 late presenters were identified. The most common <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\u2010defining conditions were oesophageal candidiasis (<jats:italic>n<\/jats:italic> = 136; 51%), wasting syndrome (<jats:italic>n<\/jats:italic> = 106; 40%) and pneumocystis pneumonia (<jats:italic>n<\/jats:italic> = 91; 34%). Fifty\u2010five patients (21%) had presented with at least one <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> indicator condition on prior contact with health care services without being offered testing for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>. Female patients and heterosexual men [not men who have sex with men (\u2018non\u2010<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>\u2019)] had a significantly higher chance of being among patients previously presenting with indicator conditions and not being tested [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 4.7; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 2.2\u201310.0; <jats:italic>P<\/jats:italic> &lt; 0.001; and <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.4; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u20135.1; <jats:italic>P<\/jats:italic> &lt; 0.01, respectively]. The most commonly missed indicator conditions were leucocytopenia (<jats:italic>n<\/jats:italic> = 13; 24%), thrombocytopenia (<jats:italic>n<\/jats:italic> = 12; 22%), oral candidiasis (<jats:italic>n<\/jats:italic> = 9; 16%), unexplained weight loss (<jats:italic>n<\/jats:italic> = 7; 13%), herpes zoster (<jats:italic>n<\/jats:italic> = 5; 9%) and cervical dysplasia\/cancer (<jats:italic>n<\/jats:italic> = 4; 20% of women). The median time between presentation with an indicator condition and the diagnosis of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection was 158.5 days [interquartile range (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) 40\u2013572 days]. Patients with oral candidiasis and unexplained weight loss had the shortest time between the \u201cmissed opportunity\u201d and the diagnosis of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection. Fifty\u2010five hospital admissions with a total cost of over <jats:styled-content style=\"fixed-case\">EUR<\/jats:styled-content> 500 000 and \u2013 most importantly \u2013 six in\u2010hospital deaths might have been prevented if <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing had been performed in patients with documented indicator conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Indicator conditions are still missed by clinicians. Women and \u2018non\u2010<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>\u2019 are at highest risk of presenting with an indicator condition but not being tested for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12403","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T16:16:48Z","timestamp":1470154608000},"page":"125-132","source":"Crossref","is-referenced-by-count":53,"title":["The late\u2010presenting <scp>HIV<\/scp>\u2010infected patient 30 years after the introduction of <scp>HIV<\/scp> testing: spectrum of opportunistic diseases and missed opportunities for early diagnosis"],"prefix":"10.1111","volume":"18","author":[{"given":"D","family":"Tominski","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Katchanov","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Driesch","sequence":"additional","affiliation":[{"name":"BioControl Jena GmbH Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MB","family":"Daley","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Liedtke","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Slevogt","sequence":"additional","affiliation":[{"name":"Septomics Research Center Jena University Hospital Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Arast\u00e9h","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Stocker","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Vivantes Auguste\u2010Viktoria Hospital Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2015.20.14.21086"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000286597.57066.2b"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001510"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2004.21251.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200101050-00012"},{"key":"e_1_2_7_7_1","unstructured":"Robert Koch Institut[Internet].HIV\/AIDS in Berlin \u2013 Eckdaten der Scha\u00a8tzung; Epidemiologische Kurzinformation des Robert Koch\u2010Instituts Stand: Ende 2013 Berlin 2014. 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