There is growing evidence that the earlier people are diagnosed with HIV and get access to care the better their clinical outcomes. Despite this, a study of nearly 45,000 HIV-infected patients conducted in the United States and Canada indicated that many people suffering from AIDs in the United States and Canada are not receiving the care they need early enough.

When patients first began clinical care for HIV during the years 1997 to 2007 their CD4 cell counts, a critical measure of immune system strength, were measured. Although the median CD4 count at first presentation increased annually over this period, from 256 cells/mm³ to 317 cells/mm³, it remains below the level currently recommended for patients to start antiretroviral therapy, 350 cells/mm³. The median age at which patients first received HIV care increased over the study period from 40 to 43 years of age.

The study was reported in the June 1, 2010 online issue of Clinical Infectious Diseases.

"The public health implications of our findings are clear: delayed diagnosis reduces survival, and individuals enter into HIV care with lower CD4 counts than the guidelines for antiretroviral therapy initiation," said study author Richard Moore, M.D., of Johns Hopkins University School of Medicine (Baltimore, MD, USA). "A delay in presentation for treatment not only increases the chance of clinical disease progression but also increases the risk of ongoing transmission."

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