Abstract
BackgroundIt is cost-effective to perform an HIV test in people with specific indicator conditions (IC) with an undiagnosed HIV prevalence of at least 0.1%. Our aim was to determine the HIV prevalence for 14 different conditions across 20 European countries.MethodsIndividuals aged 18–65 years presenting for care with one of 14 ICs between January 2012 and June 2014 were included and routinely offered an HIV test. Logistic regression assessed factors associated with testing HIV positive. Patients presenting with infectious mononucleosis-like syndrome (IMS) were recruited up until September 2015.ResultsOf 10,877 patients presenting with an IC and included in the analysis, 303 tested positive (2.8%; 95% CI 2.5–3.1%). People presenting with an IC in Southern and Eastern Europe were more likely to test HIV positive as were people presenting with IMS, lymphadenopathy and leukocytopenia/ thrombocytopenia. One third of people diagnosed with HIV after presenting with IMS reported a negative HIV test in the preceding 12 months. Of patients newly diagnosed with HIV where data was available, 92.6% were promptly linked to care; of these 10.4% were reported lost to follow up or dead 12 months after diagnosis.ConclusionThe study showed that 10 conditions had HIV prevalences > 0.1%. These 10 ICs should be adopted into HIV testing and IC specialty guidelines. As IMS presentation can mimic acute HIV sero-conversion and has the highest positivity rate, this IC in particular affords opportunities for earlier diagnosis and public health benefit.
Highlights
The HIDES 1 study (HIV Indicator Diseases across Europe Study) gave proof of concept that Indicator Condition (IC) guided HIV testing is an acceptable, feasible and effective strategy to diagnose people living with HIV in health care setting encounters [1]
Of 10,877 patients presenting with an indicator conditions (IC) and included in the analysis, 303 tested positive (2.8%; 95% CI 2.5–3.1%)
People presenting with an IC in Southern and Eastern Europe were more likely to test HIV positive as were people presenting with infectious mononucleosis-like syndrome (IMS), lymphadenopathy and leukocytopenia/ thrombocytopenia
Summary
The HIDES 1 study (HIV Indicator Diseases across Europe Study) gave proof of concept that Indicator Condition (IC) guided HIV testing is an acceptable, feasible and effective strategy to diagnose people living with HIV in health care setting encounters [1]. An audit of HIV testing in tuberculosis (TB), candida oesophagitis (OC), non-Hodgkin’s lymphoma (NHL), anal cancer (AC) cervical cancer (CC) and hepatitis B and C (HEP) across Europe was conducted in parallel and is reported elsewhere [6]; this demonstrated poor performance of IC guided testing in people presenting with well recognised AIDS-defining and non-AIDS defining indicator conditions. It is cost-effective to perform an HIV test in people with specific indicator conditions (IC) with an undiagnosed HIV prevalence of at least 0.1%. Our aim was to determine the HIV prevalence for 14 different conditions across 20 European countries
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have