Delayed HIV Diagnosis in an Elderly Female: A Case of MissedOpportunities Across Multiple Specialties

Abstract

This case highlights a significantly delayed diagnosis of HIV in a 78-year-old female, despite more than 20 clinical encounters over four years. The patient
presented with classic HIV indicator conditions, including unexplained weight loss, generalized lymphadenopathy, recurrent infections, and esophageal
candidiasis. Due to demographic biases and the absence of routine HIV screening in older, heterosexual individuals, the diagnosis was missed until advanced immunosuppression occurred. Ultimately, an HIV test conducted by the Infectious Diseases (ID) team revealed a CD4 count of 8 cells/mm³ and a viral load of 346,000 copies/mL. This case underscores the urgent need to adopt inclusive HIV testing practices and eliminate demographic profiling as a barrier to early diagnosis.