Although evidence indicates that undiagnosed cases of HIV are often found during routine screening in the ED, acute infections occur less often. Now, due to patients visiting the ED with symptoms similar to COVID-19 infection, patients newly infected with HIV are being diagnosed in greater numbers, according to David Pitrak, MD, of the University of Chicago. During the first 8 months of the COVID-19 pandemic, new cases of HIV infection—all diagnosed in the ED—were found at an annualized rate of 14.4 per year at Dr. Pitrak’s institution, compared with a rate of 6.8 during the previous 4 years. “An HIV test is part of the diagnostic and lab evaluation when we evaluate patients at high risk for COVID-19, or who are found to be positive for COVID-19,” said Dr. Pitrak. “It is vital to know their HIV status in the setting of such a viral illness.” The upsurge in acute HIV cases may be due to patients confusing acute HIV infection symptoms with COVID-19 symptoms and thus seeking treatment over concerns of the latter, changes in behavior precipitated by the pandemic, or disruptions in the care of people living with HIV and their partners or at-risk people using PrEP.
