Suboptimal HIV Testing Among Patients Admitted With Pneumonia: A Missed Opportunity
Dana C Clifton1, Meredith E Clement2, Thomas L Holland2
1Departments of Medicine and Pediatrics, Division of General Internal Medicine, Section of Hospital Medicine, Duke University School of Medicine, Durham, North Carolina.
Abstract:
Patients admitted with pneumonia are at higher risk for HIV and should be routinely screened. We examined a retrospective cohort of patients admitted to Duke University Health System with a primary diagnosis of pneumonia. During the study period, 6,951 persons were admitted with pneumonia. Of 6,646 patients without a known prior diagnosis of HIV, 1,010 (15%) had HIV testing during admission and 1,516 (23%) had a previously documented HIV test result. Forty-one (0.6%) patients had a positive HIV test during admission and 27 (0.4%) patients were diagnosed with HIV a median of 498 (IQR 112-982) days later, with median CD4 count of 64 (IQR 16-281) cells/mm3. HIV testing rates remain low in a population at high risk for HIV. At a minimum, we should be adhering to universal HIV screening recommendations, and certainly we should be screening those at higher risk. Opt-out HIV testing of pneumonia inpatients should be implemented.
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