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.

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

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