Public Health England has produced its annual report on HIV new diagnoses, treatment and care in the UK. Some key points:
The number of people living with diagnosed HIV in the UK continues to rise, with 85,489 people seen for HIV care by the end of 2014. Of 85,489 people accessing HIV care in 2014, 41% lived in London. The age of people accessing care for HIV continues to increase, with almost one in six now aged over 55. The aging cohort of people living with HIV emphasises the importance of integrated care pathways to manage co-morbidities and other complications.
HIV specialist treatment and care in the UK remains excellent. Of all people attending for care in 2014, 91% were on ART, of whom 95% were virally suppressed and very unlikely to be infectious to others.
This year, new evidence from clinical trials has demonstrated benefits for people with HIV who start ART before their CD4 count drops below 500 cells/mm3. These data have been reflected in the 2015 WHO and UK BHIVA treatment guidelines, both of which recommend starting ART as soon as possible after diagnosis.
A total of 6151 people were newly diagnosed with HIV in the UK during 2014. The number of men who have sex with men (MSM) newly diagnosed with HIV continued to rise from 2,860 men in 2010 to 3,360 men diagnosed HIV positive in 2014. New diagnoses acquired through heterosexual sex has declined over the same time period (3,440 to 2,490), largely due to a reduction in diagnoses among black African men and women (1,801 in 2010 to 1,044 in 2014). Of all new HIV diagnoses acquired through heterosexual sex the estimated proportion of those acquired in the UK has risen from 52% in 2010 to 59% in 2014, with the proportion of HIV diagnoses acquired in the UK among MSM stable over time at 76%.
A major challenge for the UK remains the timely diagnosis of HIV infection in order to start lifesaving ART and prevent onwards transmission of infection. Two out of five people newly diagnosed with HIV in 2014 had “late stage” HIV, evidenced by a CD4 count below 350, and this remains stubbornly and unacceptably high (56% in 2005). Being diagnosed late is associated with a tenfold increased risk of death within one year of diagnosis. In 2014, 613 people with HIV died, most of who were diagnosed late.