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HIV-Indicator Condition Guided Testing in a Hospital Setting.

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Life (Basel, Switzerland)
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Targeted HIV screening using indicator conditions (HIV-ICs) identified new infections, but clinician engagement needs improvement. Combining HIV-ICs with other strategies is crucial for early HIV diagnosis and better patient outcomes.

Keywords:
AIDSHIVHIV indicator conditionslate diagnosisscreening

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Medicine

Background:

  • Late diagnosis of Human Immunodeficiency Virus (HIV) infection poses significant risks to patients and the community.
  • HIV indicator conditions (HIV-ICs) screening is a strategy to identify infections in patients not typically considered at high behavioral risk.

Purpose of the Study:

  • To evaluate the effectiveness of an in-hospital HIV-ICs guided screening campaign.
  • To determine the prevalence of HIV among patients presenting with specific clinical conditions.

Main Methods:

  • An in-hospital HIV-ICs guided screening campaign (ICEBERG) was conducted in Milan, Italy, from 2019 to 2021.
  • 520 subjects were enrolled, primarily those with viral hepatitis or mononucleosis-like syndromes.
  • HIV testing was performed on all enrolled subjects.

Main Results:

  • Twenty participants tested positive for HIV, indicating a prevalence of 3.8%.
  • A substantial number of newly diagnosed individuals presented with advanced immunosuppression (40% were AIDS-presenters) and multiple comorbidities.
  • Adherence to the screening campaign was limited among non-Infectious Disease specialists, highlighting a need for enhanced clinician education.

Conclusions:

  • HIV-ICs guided testing is a valuable tool for early HIV detection, particularly in diverse clinical settings.
  • The study underscores the need for improved clinician awareness and training regarding HIV-ICs to increase screening campaign participation.
  • A multifaceted approach, integrating HIV-ICs with other screening methods, is recommended for optimizing early HIV diagnosis and management.