TY - JOUR
T1 - Improving the evidence for indicator condition guided HIV testing in Europe
T2 - Results from the HIDES II Study - 2012 - 2015
AU - Raben, Dorthe
AU - Sullivan, Ann Kathleen
AU - Mocroft, Amanda
AU - Kutsyna, Galyna
AU - Hadžiosmanović, Vesna
AU - Vassilenko, Anna
AU - Chkhartisvili, Nikoloz
AU - Mitsura, Viktar
AU - Pedersen, Court
AU - Anderson, Jane
AU - Begovac, Josip
AU - Bak Dragsted, Ulrik
AU - Bertisch, Barbara
AU - Grzeszczuk, Anna
AU - Minton, Jane
AU - Necsoi, Valentina Coca
AU - Kitchen, Maria
AU - Ajana, Faiza
AU - Sokhan, Anton
AU - Comi, Laura
AU - Farazmand, Paymaneh
AU - Pesut, Dragica
AU - De Wit, Stephane
AU - Gatell, José Maria
AU - Gazzard, Brian
AU - d'Arminio Monforte, Antonella
AU - Rockstroh, Jürgen Kurt
AU - Yazdanpanah, Yazdan
AU - Champenois, Karen
AU - Jakobsen, Marie Louise
AU - Lundgren, Jens Dilling
AU - HIDES Study Group
PY - 2019/1/1
Y1 - 2019/1/1
N2 - BACKGROUND: 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.METHODS: Individuals 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.RESULTS: Of 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.CONCLUSION: The 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.
AB - BACKGROUND: 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.METHODS: Individuals 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.RESULTS: Of 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.CONCLUSION: The 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.
U2 - 10.1371/journal.pone.0220108
DO - 10.1371/journal.pone.0220108
M3 - Review
C2 - 31408476
SN - 1932-6203
VL - 14
SP - e0220108
JO - PLoS One
JF - PLoS One
IS - 8
M1 - e0220108
ER -