Medical and societal consequences of late presentation.

Patients presenting late with HIV infection are at a higher risk of clinical events, are difficult to treat and have a higher mortality compared with those who present earlier. Indeed, being diagnosed too late for effective treatment has been shown to be a common scenario leading to death. The increased risk for opportunistic diseases and increased mortality are associated with low CD4(+) T-cell counts. In addition to the detrimental effect on the health of the individual, late presentation also creates a significant societal burden because it is associated with increased risk of HIV transmission and increased resource use. All of these factors highlight the benefit of earlier testing, diagnosis and treatment of HIV.