Feasibility and Effectiveness of Indicator Condition-Guided Testing for HIV: Results from HIDES I (HIV Indicator Diseases across Europe Study)

Improved methods for targeting HIV testing among patients most likely to be infected are required; HIDES I aimed to define the methodology of a European wide study of HIV prevalence in individuals presenting with one of eight indicator conditions/diseases (ID); sexually transmitted infection, lympho...

Celý popis

Uloženo v:

Podrobná bibliografie
Vydáno v:	PloS one Ročník 8; číslo 1; s. e52845
Hlavní autoři:	Sullivan, Ann K., Raben, Dorthe, Reekie, Joanne, Rayment, Michael, Mocroft, Amanda, Esser, Stefan, Leon, Agathe, Begovac, Josip, Brinkman, Kees, Zangerle, Robert, Grzeszczuk, Anna, Vassilenko, Anna, Hadziosmanovic, Vesna, Krasnov, Maksym, Sönnerborg, Anders, Clumeck, Nathan, Gatell, José, Gazzard, Brian, Monforte, Antonella d’Arminio, Rockstroh, Jürgen, Lundgren, Jens D.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 15.01.2013 Public Library of Science (PLoS)
Témata:	Adult Antiretroviral drugs Cancer CD4 antigen Cervix Cost analysis Cost effectiveness Dermatitis Dermatology Diagnostic Tests, Routine - methods Disease Disease transmission Drug abuse Drug therapy Dysplasia Europe - epidemiology Exanthema Family medical history Feasibility Studies Female Health care Health promotion Hepatitis Hepatitis B Herpes zoster HIV HIV (Viruses) HIV infections HIV Infections - diagnosis HIV Infections - epidemiology HIV Seropositivity - diagnosis HIV Seropositivity - epidemiology HIV tests Hospitals Human immunodeficiency virus Humans Indicators Infeccions per VIH Infections Infectious diseases Leukopenia Lymphoma Male Medical diagnosis Medical tests Medicine Middle Aged Mononucleosis Odds Ratio Patient Acceptance of Health Care Prevalence Public health Seborrheic dermatitis Sexually transmitted diseases Skin diseases STD Strategy Surveys Surveys and Questionnaires Thrombocytopenia VIH (Virus) Europe
ISSN:	1932-6203, 1932-6203
On-line přístup:	Získat plný text
Tagy:	Přidat tag Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!

Popis
Shrnutí:	Improved methods for targeting HIV testing among patients most likely to be infected are required; HIDES I aimed to define the methodology of a European wide study of HIV prevalence in individuals presenting with one of eight indicator conditions/diseases (ID); sexually transmitted infection, lymphoma, cervical or anal cancer/dysplasia, herpes zoster, hepatitis B/C, mononucleosis-like illness, unexplained leukocytopenia/thrombocytopenia and seborrheic dermatitis/exanthema, and to identify those with an HIV prevalence of >0.1%, a level determined to be cost effective. A staff questionnaire was performed. From October 2009- February 2011, individuals, not known to be HIV positive, presenting with one of the ID were offered an HIV test; additional information was collected on previous HIV testing behaviour and recent medical history. A total of 3588 individuals from 16 centres were included. Sixty-six tested positive for HIV, giving an HIV prevalence of 1.8% [95% CI: 1.42-2.34]; all eight ID exceeded 0.1% prevalence. Of those testing HIV positive, 83% were male, 58% identified as MSM and 9% were injecting drug users. Twenty percent reported previously having potentially HIV-related symptoms and 52% had previously tested HIV negative (median time since last test: 1.58 years); which together with the median CD4 count at diagnosis (400 cell/uL) adds weight to this strategy being effective in diagnosing HIV at an earlier stage. A positive test was more likely for non-white individuals, MSM, injecting drug users and those testing in non-Northern regions. HIDES I describes an effective strategy to detect undiagnosed HIV infection. All eight ID fulfilled the >0.1% criterion for cost effectiveness. All individuals presenting to any health care setting with one of these ID should be strongly recommended an HIV test. A strategy is being developed in collaboration with ECDC and WHO Europe to guide the implementation of this novel public health initiative across Europe.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Substantial contributions to acquisition of data: A. Sullivan DR MR SE AL JB KB RZ AG AV VH MK A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Revised the article critically for important intellectual content: A. Sullivan DR MR AM SE AL JB KB RZ AG AV VH MK A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Final approval of the version to be published: A. Sullivan DR MR AM SE AL JB KB RZ AG AV VH MK A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Conceived and designed the experiments: A. Sullivan DR AM A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Performed the experiments: A. Sullivan DR MR SE AL JB KB RZ AG AV VH MK A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Analyzed the data: A. Sullivan DR J. Reekie MR AM JDL. Contributed reagents/materials/analysis tools: A. Sullivan DR MR AM SE AL JB KB RZ AG AV VH MK A. Sönnerborg NC JG BG AdAM J. Rockstroh JDL. Wrote the paper: A. Sullivan DR J. Reekie MR AM JDL.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0052845