European guidance recommends that HIV testing should be offered in conditions where not identifying the presence of HIV infection may have significant adverse implications for the individual’s clinical management, regardless of the prevalence of HIV.
As untreated HIV infection causes impaired immunity, some immunosuppressive medication could have serious outcomes for patients with undiagnosed HIV. In addition, untreated HIV infection may impair the patient’s response to the immunosuppressive medication. Before you prescribe immunosuppressive biologicals you should offer an HIV test to exclude HIV infection.