Testing for patients with specified symptoms or conditions

There are a number of health conditions which may be caused by HIV infection itself, be more common in people with weakened immune systems or, for behavioural reasons, be more common in HIV-positive people than in the general population. However, in many cases, many people attending healthcare settings with these conditions are not offered HIV tests and their infection remains undiagnosed.

As well as AIDS-defining conditions such as tuberculosis and cerebral toxoplasmosis, the list of 49 conditions includes:

• Peripheral neuropathy
• Dementia
• Recurrent herpes zoster (shingles)
• Chronic diarrhoea of unknown cause
• Weight loss of unknown cause
• Cervical smear abnormalities (CIN grade 2 or 3)
• Anal cancer or pre-cancer
• Lung cancer
• Testicular cancer
• Head and neck cancer
• Any sexually transmitted infection

In all of these cases, an offer of an HIV test is recommended.

A separate list of clinical indicator diseases for paediatric HIV infection is provided in the guidelines .

Clinicians are reminded that the symptoms of primary HIV infection (seroconversion illness) include fever, rash and muscle pain. However, these symptoms can have many different causes. The guidelines recommend that whenever a patient presents with such symptoms and is “perceived to be at risk of infection”, an HIV test should be offered.

A publication by MEDFASH for non-HIV clinicians provides more information on the links between the health conditions listed above and HIV.¹