Mode of Detection of HIV Infection - A Retrospective Study of 612 Cases
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Sawhney1, Y K Sharma2, S K Sayal3
1Senior Advisor (Dermatology and STD), Base Hospital, Delhi Cantt.
Insights
Early HIV detection in the Armed Forces is crucial. Many cases are found late, often with advanced opportunistic infections like tuberculosis, highlighting the need for improved screening strategies.
Area of Science:
- Medical research
- Epidemiology
- Public health
Background:
- Analysis of HIV detection trends in the Armed Forces is essential for refining early detection strategies.
- Understanding current detection methods informs future public health interventions.
Purpose of the Study:
- To analyze the trends in the modes of detection for Human Immunodeficiency Virus (HIV) infection within the Armed Forces.
- To identify opportunities for improving early HIV diagnosis and intervention.
Main Methods:
- A retrospective study was conducted involving 612 newly diagnosed HIV-positive cases.
- Data was collected for cases diagnosed between January 1997 and August 2002.
Main Results:
- Nearly 30% of individuals had advanced HIV (Category C) at diagnosis, with tuberculosis being the most common opportunistic infection.
- Herpes zoster and blood donation screening were significant, though late, detection modes.
- Few cases were identified during acute retroviral syndrome or generalized lymphadenopathy, and only one voluntary report occurred.
Conclusions:
- There is a critical need to enhance voluntary reporting of HIV status.
- Strategies should focus on identifying more cases during the acute retroviral syndrome and persistent generalized lymphadenopathy (PGL) stages for earlier intervention.
Background:
Trends in mode of detection of HIV infection in the Armed Forces required to be analyzed to formulate future strategies for early detection.
Methods:
A retrospective study was thus conducted in 612 newly diagnosed HIV-positive cases between January 1997 to August 2002.
Results:
182(29.74%) patients had already developed Category C conditions when detected to be HIV-positive, 176(96.70%) with mycobacterial disease, majority (67.61%) of them being pulmonary tuberculosis, followed by recurrent bacterial pneumonia in 3 (1.65%), pneumocystis carinii pneumonia (PCP) in 2(1.1%) and oesophageal candidiasis in one (0.55%). Herpes zoster was the third most common mode of detection accounting for 86 (14.05%) of the cases (24.6% of them with involvement of ophthalmic branch of trigeminal nerve), after tuberculosis in 176(28.76%) and blood donors in 98(16.01%), followed by constitutional symptoms in 59(9.64%) cases, investigation for STDs in 56(9.15%), bacterial pneumonia in 6(0.98%) and oral mucosal candidiasis in only one (0.16%) case. None was detected during acute retroviral illness and only 5(0.82%) cases were detected while being investigated for generalized lymphadenopathy. Amongst the cases detected during investigation for STDs, majority (26.79%) were on STD surveillance. 22(3.60%) cases tested positive when their spouses were detected to be HIV-positive, 20(3.27%) while being screened for surgery, 4(0.65%) for posting abroad and 2(0.32%) each during investigation when child was found HIV-positive and investigation for HBV infection. Remaining 69(11.27%) patients were detected during investigation of various related or unrelated conditions including one (0.16%), which reported voluntarily after a high-risk exposure.
Conclusion:
There is a need to encourage voluntary reporting and identify more number of cases during acute retroviral syndrome and PGL stage.
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