As HIV infection may be non-symptomatic for many
years, many HIV-infected individuals are not aware of
their infection. At a certain point in time non-specific
symptoms may occur for which patients are likely be
referred to internal medicine outpatient clinics. In the
absence of systematic screening for HIV and in particular
in patients who do not have classical risk factors for HIV,
the diagnosis of HIV infection may easily be overlooked.
In this manuscript it is illustrated that this diagnostic
and therapeutic delay can lead to increased morbidity
and mortality. Moreover, undiagnosed individuals are
on average more likely to transmit HIV than diagnosed
individuals. It is important for public health to identify
people harbouring HIV infection, as this is expected
to reduce the number of new infections. HIV infection
should be considered a possible cause of unexplained
symptoms in an early stage of the diagnostic process, in
particular in patients with symptoms such as unexplained
fever, lymphadenopathy or weight loss or in the presence of conditions suggestive of possible immune deficiency, regardless of the absence of risk factors.