Diagnosis, indicator diseases and monitoring of HIV (including resistance testing)

Abstract

In the UK it is estimated that >110,000 people are living with HIV, 95% of whom are aware that they have the virus. Testing, diagnosis, monitoring and integrated healthcare free at the point of access mean that the UK is on track to reach the UNAIDS 95-95-95 targets. Fourth-generation testing is the gold standard and can detect HIV after a window period of around 17–21 days. In the absence of opt-out or opt-in testing, and in areas of lower prevalence, HIV-associated ‘indicator diseases’ should trigger testing. The assessment of newly diagnosed patients should include a thorough history, examination and relevant investigations. In most cases, antiretroviral therapy (ART) should be started as soon as possible. People with HIV should be followed up in specialist HIV services for monitoring, support, treatment and enhanced surveillance for HIV- and ART-related issues.