The Centre for Health Protection (CHP) has called on people to get tested for HIV as it revealed an increase in the proportion of patients getting diagnosed at advanced stages of the infection.
Dr Lee Cheuk-kwong (left) and Dr Bonnie Wong (left) at a CHP press conference on November 26, 2024. Photo: James Lee/HKFP.
Speaking at a press conference on Tuesday, Bonnie Wong, a consultant for the CHP’s Special Preventative Programme, said there had been a rise in the percentage of “late presenters.” The term refers to people diagnosed with HIV at an advanced stage of the infection, often when their immune system is compromised or they are already displaying AIDS symptoms,
Though the number of new HIV cases in Hong Kong has been on the decline since peaking in 2015, the proportion of late presenters has risen from 28 per cent of yearly cases in 2014 to 47 per cent in 2023.
Wong urged early testing, saying that late presenters face a heightened risk of transmission, as well as a tenfold mortality risk.
“When they find out late, when the virus is still active without treatment and they don’t realise they are infected, the risk of transmission in the community is much higher than for people who find out early,” she said.
Diagnoses for older age groups
A total of 85 HIV transmission cases were recorded in the third quarter of 2024, of which 22 had progressed to AIDS. Out of the 22, there were 18 who were only diagnosed with HIV when their virus had advanced to AIDS.
File photo: Bermix Studio/Unsplash.
The increase in the proportion of late presentation cases did not mean the number of those cases had increased, Wong added. Amid a drop in overall cases, including normal HIV infections, late presentation cases took up a larger proportion over the past decade.
Of the cases recorded during this year’s third quarter, more than 43 per cent were identified as late presenters, based on the amount of “CD4” immune system cells in them. A lower CD4 cell count indicates a weaker immune system.
Wong referred to a case involving a 60-year-old woman who was diagnosed with HIV and AIDS after seeking medical care due to prolonged diarrhoea and weight loss in September 2021. She had four CD4 cells per cubic millimetre of blood in 2021, which gradually increased to 323 in June 2024 following treatment.
The CHP also presented findings that the number of HIV cases above 50 years of age had seen an increase in this year’s third quarter, as Wong pointed to older ages at diagnosis being commonly associated with late presentation.
Hospital Authority. File photo: Tom Grundy/HKFP.
The centre recorded 10 male and three female cases aged between 50 and 59, and nine male cases aged 60 to 69.
Wong identified reasons for late presentation including inadequate knowledge and awareness of HIV and testing resources, low self-perceived risk of infection, fear of a potential positive HIV diagnosis, as well as discrimination.
Over the past decade, there has been a marked drop in cases among younger people over the Wong said, while the cases for those older had increased.
The CHP called on people at risk of HIV infection to get tested, including homosexual men, transgender people, sex workers and their clients, people who inject drugs, and people who have multiple sex partners.
People who have had sex and are uncertain of their HIV status should also get tested at least once, Wong said, citing figures showing that about one in five newly infected cases were not part of a high-risk demographic.
