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We read with interest the letter from Natarajan et al regarding extensive unexpected antiretroviral resistance in an African immigrant patient.1 The failure of HIV positive patients to disclose their status to healthcare workers has previously been documented with adverse clinical outcomes.2
In this case series, we present five individuals who had previously been diagnosed with HIV, who then re-presented for HIV antibody testing and subsequent treatment without disclosing their HIV positive status. All cases were of African origin and diagnosed between October 2002 and February 2003.
We were alerted to the possibility of a previously known HIV diagnosis in this woman as her mean corpuscular volume (MCV) was raised at 118 fl and she had features suggestive of the lipodystrophy syndrome. This patient finally revealed her …