RESEARCH PAPER
Rationales for indicator condition-based HIV testing data from the Hospital for Infectious Diseases in Warsaw – one-year observation
Submission date: 2016-12-18
Final revision date: 2017-07-31
Acceptance date: 2017-10-04
Publication date: 2017-10-10
HIV & AIDS Review 2017;16(3):191-194
KEYWORDS
indicator conditionsoptimisationmononucleosis-like syndromemissed opportunity for HIV testingroutine HIV testing
TOPICS
ABSTRACT
Introduction: The European study HIDES (HIV Indicator Disease Across Europe Study) has shown that indicator condition (IC)-based HIV testing may increase the number of detected HIV infections among patients with a given medical conditions. Currently routine HIV testing for IC is not covered by public healthcare in Poland, which may delay or miss the opportunity for HIV diagnosis. The aim of the study was to evaluate HIV testing patterns among patients presenting with specific IC-ongoing mononucleosis-like illness (mononucleosis) in emergency departments (ED).
Material and methods: We performed retrospective analysis of patients with mononucleosis referred from ED to hospital departments for further diagnostics within the past 12 months.
Results: In total 173 patients were consulted in ED with mononucleosis, that is 94 men and 79 women, with median age of 26 years. Seventy-two (41.6%) patients were admitted to hospital, among whom 54 (75%) were offered an HIV test and all expressed consent. Four patients (5.5%) were diagnosed with HIV, referred to an HIV clinic, and linked to care. According to analyses, 68% of patients missed the opportunity for HIV testing, 58% in ED due to lack of such healthcare program, and 10% of unknown reason. With the presented rate, this translated to eight HIV patients who may still remain unaware of HIV infection.
Conclusions: The rate of HIV diagnosis among patients hospitalised due to mononucleosis was high, confirming the benefit of routine testing of this group of patients. Standards of care for mononucleosis should include routine HIV testing, which needs additional financing and attention from public healthcare representatives and other stakeholders.
Material and methods: We performed retrospective analysis of patients with mononucleosis referred from ED to hospital departments for further diagnostics within the past 12 months.
Results: In total 173 patients were consulted in ED with mononucleosis, that is 94 men and 79 women, with median age of 26 years. Seventy-two (41.6%) patients were admitted to hospital, among whom 54 (75%) were offered an HIV test and all expressed consent. Four patients (5.5%) were diagnosed with HIV, referred to an HIV clinic, and linked to care. According to analyses, 68% of patients missed the opportunity for HIV testing, 58% in ED due to lack of such healthcare program, and 10% of unknown reason. With the presented rate, this translated to eight HIV patients who may still remain unaware of HIV infection.
Conclusions: The rate of HIV diagnosis among patients hospitalised due to mononucleosis was high, confirming the benefit of routine testing of this group of patients. Standards of care for mononucleosis should include routine HIV testing, which needs additional financing and attention from public healthcare representatives and other stakeholders.
REFERENCES (31)
2.
HIV Indicator Conditions: Guidance for Implementing HIV Testing In Adults In Health Care Settings. Available at: http://hiveurope. eu/Portals/0/Guidance.pdf.pdf.
4.
Schedule of implementation of the National Program for HIV and AIDS prevention prepared for 2012-2016. The National AIDS Centre, 2012.
5.
Mocroft A, Lundgren JD, Sabin ML, et al. Risk factors and outcomes for late presentation for HIV-positive persons in Europe: results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE). PLoS Med 2013; 10: e1001510.
6.
Reekie J, Kowalska JD, Karpov I, et al. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: the EuroSIDA study. PLoS One 2012; 7: e41673.
7.
Smith CJ, Ryom L, Weber R, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384: 241-248.
8.
Baggaley R. HIV for non-HIV specialists, Diagnosing the undiagnosed 2008. Available at: http://www.medfash.org.uk/publ....
9.
Sullivan AK, Raben D, Reekie J, et al. Feasibility and effectiveness of indicator condition-guided testing for HIV: results from HIDES I (HIV indicator diseases across Europe study). PLoS One 2013; 8: e52845.
10.
Gullón A, Verdejo J, de Miguel R, et al. Factors associated with late diagnosis of HIV infection and missed opportunities for earlier testing. AIDS Care 2016; 28: 1296-1300.
11.
Rayment M, Thornton A, Mandalia S, et al. HIV testing in non-traditional settings – the HINTS study: a multi-centre observational study of feasibility and acceptability. PLoS One 2012; 7: e39530.
12.
AgustÍ C, Montoliu A, Mascort J, et al. Missed opportunities for HIV testing of patients diagnosed with an indicator condition in primary care in Catalonia, Spain. Sex Transm Infect 2016; 92: 387-392.
14.
Hsu DT, Ruf M, O’Shea S, et al. Diagnosing HIV infection in patients presenting with glandular fever-like illness in primary care: are we missing primary HIV infection? HIV Med 2013; 14: 60-63.
15.
UK Collaborative HIV Cohort (UK CHIC) Steering Committee; Sabin CA, Schwenk A, Johnson MA, et al. Late diagnosis in the HAART era: proposed common definitions and associations with mortality. AIDS 2010; 24: 723-727.
16.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365: 493-505.
17.
Raben D, Mocroft A, Rayment M, et al. Auditing HIV Testing Rates across Europe: Results from the HIDES 2 Study. PLoS One 2015; 10: e0140845.
18.
Kowalska JD, Wójcik G, Rutkowski J, et al. Modelling the cost-effectiveness of HIV care in Poland shows clear benefit while transmission risk is considered in the calculation Poster Nr P327 presented at the HIV Drug Therapy Congress, Glasgow 2016.
19.
Podlasin RB, Wiercinska-Drapalo A, Olczak A, et al. Opportunistic infections and other AIDS-defining illnesses in Poland in 2000-2002. Infection 2006; 34: 196-200.
20.
Zalewska-Schonthaler N, Schonthaler-Humiecka J, Podlasin R, et al. Tuberculosis and mycobacteriosis important opportunistic disease in AIDS patients. Przegl Epidemiol 2001; 55 Suppl 3: 117-125.
21.
Kowalski J, Cholewinska G, Pyziak-Kowalska K, et al. The Spectrum of Malignancies among Adult HIV Cohort in Poland between 1995 and 2012: A Retrospective Analysis of 288 Cases. Contemp Oncol (Pozn) 2015; 19: 226-235.
22.
Rosinska M, Marzec-Bogustawska A, Janiec J, et al. High percentage of recent HIV infection among HIV-positive individuals newly diagnosed at voluntary counseling and testing sites in Poland. AIDS Res Hum Retroviruses 2013; 29: 805-813.
23.
Szostakowska M, Pogoda I, Ulanicka M, et al. Final Report. Evaluation of the National Programme for preventing HIV infection and providing interventions for people living with HIV/AIDS for years 2012-2015. Available at: https://politykaspoleczna.um.w....
24.
Horban A, et al. Polish AIDS Society Recommendations (PTN AIDS) 2016. Warsaw 2016; pp. 10-17.
25.
Nakagawa F, Lodwick RK, Smith CJ, et al. Projected life expectancy of people with HIV according to timing of diagnosis. AIDS 2012; 26: 335-343.
27.
Ankiersztejn-Bartczak M, Firlag-Burkacka E, Czeszko-Paprocka H, et al. Factors responsible for incomplete linkage to care after HIV diagnosis: preliminary results from the Test and Keep in Care (TAK) project. HIV Med 2015; 16: 88-94.
28.
Kowalska JD, Shepherd L, Ankiersztejn-Bartczak M, et al. Poor Linkage to Care Despite Significant Improvement in Access to Early cART in Central Poland – Data from Test and Keep in Care (TAK) Project. PLoS One 2016; 11: e0162739.
29.
Camoni L, Raimondo M, Regine V, et al. Late presenters among persons with a new HIV diagnosis in Italy, 2010-2011. BMC Public Health 2013; 13: 281.
30.
90-90-90 An ambitious treatment target to help end the AIDS epidemic. Available at: http://www.unaids.org/sites/de....
31.
HIDES 2 (HIV Indicator Diseases Across Europe Study) 2011-2015. Available at: http://newsite.hiveurope.eu/Fi... HIDES-2.
| eISSN: | 1732-2707 |
| ISSN: | 1730-1270 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
