An increasing proportion of HIV-infected individuals are diagnosed late, with CD4 T-cell counts below 350 cells/mm³ or with a symptomatic HIV disease. These patients, known as late presenters, make up to 50-60% of patients presenting for first care throughout Europe and North America, with quite a large range being mainly due to differences in definitions and geographical settings. Several epidemiological factors have been thus far associated with late HIV diagnosis that include older patients, females, homosexual men, and migration.

Late presenters represent one of the major challenges in the clinical management of HIV/AIDS. Indeed, it has been well documented that they display an increased risk of HIV- and non-HIV-related clinical events and death. Furthermore, lowest ranges of CD4 counts at HAART initiation are associated with a more relent and overall less efficient immune reconstitution even after years of virologically suppressive HAART.

Corollary to these findings is the need for the most careful therapeutic choice for these patients, also taking into account the risks of transmitted resistance, viral evolution, archived mutations, and reemerging mutation after drug exposure that might be particularly harmful in these critical patients.

We are particularly interested in manuscripts that help better detail the phenomenon of late diagnosis and consequent late presentation throughout the world, with respect to epidemiological, clinical, immunopathogenetic, and virological aspects.

In particular, we would particularly welcome papers reporting epidemiological data on HIV late presentations in diverse contexts, further aiming to understand different risk factors/behaviors that could possibly impact on preventive strategies. We are also interested in papers dealing with clinical and therapeutical issues and studies describing efficacy of specific therapeutic approaches including immune adjuncts to HAART. Potential topics include, but are not limited to:

• Definition and epidemiology
• Clinical and social aspects
• Immunopathogenetic issues
• Tropism and viral resistance
• Treatment option and response to therapy

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