Prevalence of HIV virus among patients undergoing continuous ambulatory peritoneal dialysis

It is unclear whether patients should be tested for the presence of HIV antibody. This test has taken upon itself a significance beyond a simple hemoglobin. Extreme views on testing are prevalent, both from the Centers for Disease Control, which does not recommend routine testing, to physicians advocating screening. The prevalence of HIV virus in our population undergoing continuous ambulatory peritoneal dialysis was investigated. Eighty-two patients ranging in age from 7-72 years were screened. There were seven positive results by both ELISA and Western Blot assays. Four had no risk factors, except for transfusion therapy before HIV screening. Three were known homosexuals. Only two of the HIV positive patients and three of the rest of the dialysis population had serologic markers for Hepatitis B infection. This 9% prevalence was much higher than expected. Although the data suggest that the risk to the health care worker is low, current recommendations to treat all patients as if they may be HIV positive protect the hospital or dialysis facility but may be unworkable. The health care workers attention is not focused because they do not differentiate between low and high risk patient groups. Furthermore, the number of patients who acquired the virus prior to routine screening is unknown. Because most dialysis patients were alive and transfused during this time period they may have inadvertently acquired the virus. If others share these findings, the implications for control of this disease are frightening, as the risk of transmission to patients' sexual partners is not inconsequential. I believe these findings support routine screening for HIV antibody.