Most physicians are unable to use clinical skills to differentiate those who should and should not be tested for HIV infection. This happens despite the belief that early HIV infection presents with a well recognized flu-like syndrome, as suggested in a study published July 15 in Journal of the American Medical Association (JAMA).
Researchers at the BC Centre for Excellence in HIV/AIDS and University of British Columbia, Oregon Health and Science University, and Duke University Medical Centre analyzed data from over 24,000 patients, and discovered physicians have great difficulty recognizing the presence or absence of early HIV infection through clinical exam alone.
During the period of early HIV infection, past research showed that 50 to 90 percent of patients develop one or more of the following symptoms: fever, nausea/vomiting, weight loss, rashes, oral ulcers, and swollen lymph glands. While identifying HIV infection early can greatly contribute to reduced mortality and the likelihood of further HIV transmission, these symptoms are too non-specific for physicians to recognize, whereas the absence of symptoms does not reliably exclude infection.
"This study is not meant to be critical of physicians because of the limitations of our ability to discern who should and should not be tested for HIV infection," says Dr. Evan Wood, lead author and Canada Research Chair in Inner City Medicine at the University of British Columbia Faculty of Medicine. "Rather, this study highlights the importance of routine HIV testing, just like we routinely test for other health conditions."