LETTER
Undocumented HIV Infection
Susan Andrews, MD;
Dominick Tammaro, MD; and
Michael D. Stein, MD
15 September 1995 | Volume 123 Issue 6 | Page 470
TO THE EDITOR:
Craven and colleagues [1] recently suggested that policies should exist to document HIV infection before the initiation of care. Using a case–control design, these investigators obtained data from 7 index cases and 70 controls and found three factors associated with factitious HIV infection. We believe that their results may not be entirely reliable. The characteristics of the index cases found to be predictive of factitious HIV disease were based in part on historical information provided by those patients. However, because these historical factors (HIV-positive partner, history of attempted suicide) may also be falsely reported, their sensitivity or validity as predictors is unknown.
In addition, the prevalence of factitious HIV disease at the authors' hospital is not provided. The cost of screening all new patients to discover a potentially small number of factitious HIV-positive patients may not be justified, especially because this group of patients, with high CD4 counts and no evidence of opportunistic infections, will probably not be subjected to expensive therapies or have preferred access to limited resources. Further data are needed before the policy of retesting all patients who report HIV seropositivity can be justified.
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Author and Article Information
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Brown University Rhode Island Hospital; Providence, RI 02903
1. Craven DE, Steger KA, La Chapelle R, Allen DM. Factitious HIV infection: the importance of documenting infection. Ann Intern Med. 1994; 121:763-6.
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