Routine HIV testing program in the University Infectious Diseases Centre in Lithuania: a four-year analysis

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• HIV transmission remains a significant public health concern in Eastern Europe, with a high incidence of late diagnoses.
• Infectious disease departments are ideal settings for expanded HIV testing due to patient demographics.
• Integrated, opt-out rapid HIV testing programs are needed to improve early detection and care access.

Purpose of the Study:

• To evaluate the feasibility and clinical effectiveness of an integrated, opt-out routine, rapid HIV testing program.
• To compare the outcomes of routine HIV testing with targeted testing strategies.

Main Methods:

• A retrospective four-year study (2010-2014) comparing two periods of an HIV screening program.
• Pilot study: routine HIV testing for inpatients aged 18-55 in one department.
• Second period: expanded routine HIV testing for inpatients aged 18-65, with targeted testing in outpatient and other inpatient departments.

Main Results:

• Routine testing in the second period showed a higher eligibility (75.9%) and testing rate (88.6%) compared to the pilot study.
• HIV prevalence was 0.23% in routine testing groups versus 0.14% in targeted testing groups, both above the 0.1% cost-effectiveness threshold.
• Routine testing identified more patients with earlier disease stages and a higher proportion of heterosexually transmitted HIV infections.

Conclusions:

• Routine HIV testing in infectious disease admissions is acceptable, feasible, sustainable, and clinically effective.
• Routine testing facilitates earlier HIV diagnosis and identifies more cases of heterosexual transmission compared to targeted testing.
• The program demonstrated cost-effectiveness, supporting its wider implementation.