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Title: Feasibility and effectiveness of indicator condition-guided testing for HIV: results from HIDES I (HIV indicator diseases across Europe study)
Author: Sullivan, Ann K.
Raben, Dorthe
Reekie, Joanne
Rayment, Michael
Mocroft, Amanda
Esser, Stefan
León García, Agathe
Begovac, Josip
Brinkman, Kees
Zangerle, Robert
Grzeszczuk, Anna
Vassilenko, Anna
Hadziosmanovic, Vesna
Krasnov, Maksym
Sönnerborg, Anders
Clumeck, Nathan
Gatell, José M.
Gazzard, Brian
Arminio Monforte, Antonella d'
Rockstroh, Jürgen Kurt
Lundgren, Jens D.
Keywords: VIH (Virus)
Infeccions per VIH
HIV (Viruses)
HIV infections
Issue Date: 15-Jan-2013
Publisher: Public Library of Science (PLoS)
Abstract: 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.
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It is part of: PLoS One, 2013, vol. 8, num. 1
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

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