PDF(Pubmed)
Abstract：
HIV testing remains an important tool in identifying people living with HIV/AIDS (PLWHA). An early diagnosis of HIV can lead to a prolonged life expectancy if treatment is initiated promptly. Indicator conditions can be the first sign of an HIV infection and should therefore be recognised and consequently a HIV test should be carried out. Testing should occur in all individuals as sexuality can be experienced by everyone, and stigma can lead to the exclusion of vulnerable groups, leading to a gap in diagnosis and treatment [1, 2].
A 63-year-old man, who identifies as bisexual and has had an intellectual disability since birth, presented at our health care centre for HIV testing. A decade ago, the patient was diagnosed with Stage III Diffuse Large B-cell Non-Hodgkin Lymphoma, an AIDS defining cancer. The patient presented at a Haematology and Oncology department 3 months prior, due to a weight loss of 10 kg over the past 5 months. Oral thrush, an HIV-indicator condition, had been diagnosed by the otolaryngologists shortly before. During this medical evaluation, pancytopenia was identified. Despite the presence of indicator conditions, the patient was never tested for HIV in the past. Staff members from the care facility for intellectually disabled suggested conducting a HIV test in our clinic through the public health department, where HIV positivity was revealed. The AIDS-defining diagnosis, along with a CD4 + cell count of 41/µl, suggests a prolonged period of HIV positivity.
Due to the presence of existing indicator conditions, an earlier HIV diagnosis was possible. We contend that most of the recent illnesses could have been prevented if earlier testing had been carried out. Therefore, patients presenting with AIDS indicator conditions, including those with mental disabilities, should be given the opportunity to be tested for HIV. HIV/AIDS trainings should be made available to health care professionals as well as to personnel interacting with vulnerable groups.
A 63-year-old man, who identifies as bisexual and has had an intellectual disability since birth, presented at our health care centre for HIV testing. A decade ago, the patient was diagnosed with Stage III Diffuse Large B-cell Non-Hodgkin Lymphoma, an AIDS defining cancer. The patient presented at a Haematology and Oncology department 3 months prior, due to a weight loss of 10 kg over the past 5 months. Oral thrush, an HIV-indicator condition, had been diagnosed by the otolaryngologists shortly before. During this medical evaluation, pancytopenia was identified. Despite the presence of indicator conditions, the patient was never tested for HIV in the past. Staff members from the care facility for intellectually disabled suggested conducting a HIV test in our clinic through the public health department, where HIV positivity was revealed. The AIDS-defining diagnosis, along with a CD4 + cell count of 41/µl, suggests a prolonged period of HIV positivity.
Due to the presence of existing indicator conditions, an earlier HIV diagnosis was possible. We contend that most of the recent illnesses could have been prevented if earlier testing had been carried out. Therefore, patients presenting with AIDS indicator conditions, including those with mental disabilities, should be given the opportunity to be tested for HIV. HIV/AIDS trainings should be made available to health care professionals as well as to personnel interacting with vulnerable groups.
摘要：
背景：HIV检测仍然是识别HIV/AIDS患者（PLWHA）的重要工具。如果及时开始治疗，艾滋病毒的早期诊断可以延长预期寿命。指标条件可能是艾滋病毒感染的第一个迹象，因此应该得到承认，因此应该进行艾滋病毒检测。测试应该发生在所有人身上，因为每个人都可以体验到性行为，污名会导致弱势群体的排斥，导致诊断和治疗的差距[1，2]。
方法：一个63岁的男人，自出生以来就有智力残疾的双性恋者，在我们的卫生保健中心进行艾滋病毒检测。十年前,患者被诊断为III期弥漫性大B细胞非霍奇金淋巴瘤，艾滋病定义癌症。患者3个月前在血液和肿瘤科就诊，由于在过去的5个月中体重减轻了10公斤。口腔鹅口疮,艾滋病毒指标状况，不久前被耳鼻喉科医生诊断出来.在这次医学评估中,发现全血细胞减少症。尽管存在指标条件，该患者过去从未接受过HIV检测。智障人士护理机构的工作人员建议通过公共卫生部门在我们的诊所进行艾滋病毒检测，在那里发现了艾滋病毒阳性。定义艾滋病的诊断，CD4+细胞计数为41/μl，表明艾滋病毒阳性的时间延长。
结论：由于存在现有指标条件，早期的HIV诊断是可能的。我们认为，如果进行更早的检测，大多数最近的疾病都是可以预防的。因此,出现艾滋病指示状况的患者，包括那些有精神残疾的人，应该有机会接受艾滋病毒检测。应向保健专业人员以及与弱势群体互动的人员提供艾滋病毒/艾滋病培训。
方法：一个63岁的男人，自出生以来就有智力残疾的双性恋者，在我们的卫生保健中心进行艾滋病毒检测。十年前,患者被诊断为III期弥漫性大B细胞非霍奇金淋巴瘤，艾滋病定义癌症。患者3个月前在血液和肿瘤科就诊，由于在过去的5个月中体重减轻了10公斤。口腔鹅口疮,艾滋病毒指标状况，不久前被耳鼻喉科医生诊断出来.在这次医学评估中,发现全血细胞减少症。尽管存在指标条件，该患者过去从未接受过HIV检测。智障人士护理机构的工作人员建议通过公共卫生部门在我们的诊所进行艾滋病毒检测，在那里发现了艾滋病毒阳性。定义艾滋病的诊断，CD4+细胞计数为41/μl，表明艾滋病毒阳性的时间延长。
结论：由于存在现有指标条件，早期的HIV诊断是可能的。我们认为，如果进行更早的检测，大多数最近的疾病都是可以预防的。因此,出现艾滋病指示状况的患者，包括那些有精神残疾的人，应该有机会接受艾滋病毒检测。应向保健专业人员以及与弱势群体互动的人员提供艾滋病毒/艾滋病培训。
