One of the first important outcomes of the HIV in Europe Initiative click here has been the start of a consensus process

to identify and begin to implement a unified definition of late presentation. Surveillance to identify the exact extent of the problem of late diagnosis of HIV infection has been complicated because there are more than 20 different definitions. A common definition of what exactly the term ‘late presenter’ means is essential if late presentation is to be more effectively dealt with by public health authorities across Europe and elsewhere. The definition, presented at the 2009 conference, and later in the same month at the European AIDS Clinicians Society Conference in Cologne, is an individual presenting for care of his/her

HIV infection with a CD4 count below 350 cells/μL or with an AIDS diagnosis [8]. A manuscript of a position paper focusing on the definition, the rationale behind it and its potential consequences is in progress. Estimates of the size of the infected MDV3100 purchase population in Europe remain unreliable, and a more comprehensive and concerted approach can help all countries to produce more robust data. The project initiated by HIV in Europe and presented at the conference aims to document the ways to estimate the size of the infected but not yet diagnosed population in order to ADP ribosylation factor develop clear guidance for countries on how

to estimate this number, and on which data need to be collected in order to do so. The report will be released in 2010 and will support advocacy for encouraging countries to carry out estimates in order to stimulate more complete collection of surveillance data. The concept of indicator disease-guided testing is an approach through which health care practitioners can be encouraged to test more patients based on suspicion of HIV infection. Few data on HIV prevalence exist for various conditions and diseases where HIV prevalence is thought to be higher than in the general population. The pilot study initiated by HIV in Europe assesses HIV prevalence in eight indicator diseases in specific populations. The project includes 17 centres in 14 countries, and the plan is to screen 7500 persons with an indicator disease for HIV. Results will be published in 2010, followed by a second phase of the study to include other potential indicator diseases and enable cross-country comparisons. It was argued that efforts should be made to reach a wide range of medical disciplines involved in indications for HIV testing. Further, the working group raised concern that at present not all occurrences of AIDS-defining events lead to HIV testing in many countries, a situation that is in particularly urgent need of attention from national policy-makers.