In response to both letters
The main objectives of our lesson were to focus on the need for early HIV testing in those patients with an unusual disease course, whether in a neurological or general medical setting, even in the case of an initial denial of a specific risk factor, and to emphasise the prolonged diagnostic course and the delay in management that can result in its absence.
I have been made aware as a result of the responses obtained in relation to our article that our lesson seemed to suggest that our patient had contracted HIV infection by caring for her sister who had died of AIDS and that no source-tracing had been performed, and for this I, on behalf of all the authors of the article, would like to apologise. However, I have to state that the regional HIV specialist team was involved once our patient's diagnosis was confirmed and an attempt to trace the source of the infection was indeed made. This revealed that the patient had been, at some point, in sexual contact with her sibling's spouse (who had been HIV positive at the time) and had contracted the disease sexually and not by caring for her ailing sister as our article seemed to suggest.
I would also like to take this opportunity to reiterate that in such a setting, the absence of an early HIV test might result in a prolonged and tortuous investigatory course, a delayed definitive diagnosis and a delay in treatment of HIV/AIDS and its associated conditions.
- © 2009 Royal College of Physicians
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