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Improving the evidence for indicator condition guided HIV testing in Europe: Results from the HIDES II Study - 2012 - 2015

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  • Dorthe Raben
  • Ann Kathleen Sullivan
  • Amanda Mocroft
  • Galyna Kutsyna
  • Vesna Hadžiosmanović
  • Anna Vassilenko
  • Nikoloz Chkhartisvili
  • Viktar Mitsura
  • Court Pedersen
  • Jane Anderson
  • Josip Begovac
  • Ulrik Bak Dragsted
  • Barbara Bertisch
  • Anna Grzeszczuk
  • Jane Minton
  • Valentina Coca Necsoi
  • Maria Kitchen
  • Faiza Ajana
  • Anton Sokhan
  • Laura Comi
  • Paymaneh Farazmand
  • Dragica Pesut
  • Stephane De Wit
  • José Maria Gatell
  • Brian Gazzard
  • Antonella d'Arminio Monforte
  • Jürgen Kurt Rockstroh
  • Yazdan Yazdanpanah
  • Karen Champenois
  • Marie Louise Jakobsen
  • Jens Dilling Lundgren
  • HIDES Study Group
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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.

Original languageEnglish
Article numbere0220108
JournalPLoS One
Issue number8
Pages (from-to)e0220108
Publication statusPublished - 1 Jan 2019

ID: 57878307