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Don't forget secondary services!
- Edmund L Ong, Nikhil Premchand, Katherine Golds (20 May 2009)
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Edmund L Ong, Consultant Physician Newcastle General Hospital NE4 6BE, Nikhil Premchand, Katherine Golds
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The UK National Guidelines for HIV Testing 2008 advocates a strategy towards opt-out HIV testing in a variety of new settings including those aged 15-59 years who register in primary care and those who are admitted to hospital in areas where the prevalence of HIV is more than two in 1000. It is important that we don't forget secondary care services as we recently conducted an audit (1) in Newcastle determining the number of newly diagnosed with HIV in 2008; in summary 90 patients had their HIV care initiated or taken over by our department of whom 46 (51%) had been newly diagnosed in 2008. Of the newly diagnosed patients, 27 (59%) were diagnosed as late presenters and their median CD4 was 83 cells/ěl (Range 4 -440 cells/ěl). Ten of these 27 patients (37%) had a history of having a previous indicator disease with 13 of 27 (48%) having an AIDS defining illness on or prior to presentation. 15 of 27 late presenters were referred from hospital physicians, 5 from sexual health services, with 4 diagnosed by their general practitioners, 2 in the ID unit and one from the blood transfusion service. One of the major challenges, as highlighted by the editorial, is how can we normalise HIV testing for patients accessing secondary health care services and that they would find the offer of HIV testing as acceptable as any other investigations. Ref:1. Premchand N, Golds K, Ong ELC. Diagnosing the undiagnosed - the real world experience froma northeast England regional infectious diseases unit. HIV Medicine 2009;Vol1;Supplement1;P93 Competing interests: None declared |
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