WJA  Vol.3 No.3 , September 2013
Diagnosis of HIV Delay: Lost Opportunities
Abstract

The diagnosis delay in new cases of HIV infection is a frequent fact. Our objective was to detect and analyse the lost opportunities and describe the characteristics of these patients. Method: The search was done by a revision of personal histories of new diagnosis of HIV infection from 1st January to 31st December 2011 in the database of VACH. We selected those that had consulted a doctor in the previous year in the Emergency area, Primary Care and Specialised Consultations in the database of the histories of the Public Health Service. We called low attendance if they came 1 - 3 times and high if over 3. We grouped patients into those that fulfilled criteria of diagnosis delay by count of CD4s. We called no diagnosis delay to those that had count of CD4 over 350, diagnosis delay under 350 and advanced disease under 200. Results: There were 107 new cases. The global percentage of DD was 61.7% of cases. From these, 45.38% fulfilled criteria of AD. It was possible to find information about the existence of previous sanitary attendance in 59 patients. From these 58% were diagnosed with delay, fulfilling criteria of AD in 27%. The predominant means of infection was sexual. 35 patients attended a healthcare level, 19 two and 5 three. 47.5% consulted over 3 times. They requested a total of 274 consultations. Discussion: The diagnosis delay is a reality. It took our attention that from 59 patients having requested previous medical assistance 58% were diagnosed with delay and 27% fulfilled criteria of AD. We found that almost half of them had been attended in 4 and up to 14 times, in some occasions with suggestive symptoms of HIV infection. Facing this discovery we think that some interventions should be undertaken to get an early diagnosis and the control of the outbreak.


Cite this paper
P. Jiménez-Aguilar, A. Palacios, G. García-Dominguez, J. Borrallo-Torrejon, E. Vergara-Moragues, E. Cruz-Rosales and A. Campos, "Diagnosis of HIV Delay: Lost Opportunities," World Journal of AIDS, Vol. 3 No. 3, 2013, pp. 197-200. doi: 10.4236/wja.2013.33026.
References

[1]   Plan Nacional sobre el Sida. Ministerio de Sanidad, Política Social e Igualdad. Instituto de Salud Carlos III. Vigilancia Epidemiológica del VIH/Sida en Espana. Figures 7-10, Novembre 2011, pp. 24-25.

[2]   A. López, R. Palacios, D. Merino, J. Y. Santos and Sociedad Andaluza de Enfermedades Infecciosas, “Retraso Diagnóstico de la Infección por el VIH en Andalucía,” Enfermedades Infecciosas y Microbiología Clínica, Vol. 29, No. 8, 2011, pp. 639-640. doi:10.1016/j.eimc.2011.02.019

[3]   D. Carnicer-Pont, N. Y. Vives and J. Barbará, “Epidemiología de la Infección por Virus de la Inmunodeficiencia Humana. Retraso en el Diagnóstico,” Enfermedades Infecciosas y Microbiología Clínica, Vol. 29, No. 2, 2010, pp. 144-151. doi:10.1016/j.eimc.2010.11.010

[4]   J. Oliva, S. Galindo, N. Vives and A. Y. Arrillaga Cols, “Retraso Diagnóstico de la Infección por el Virus de la Inmunodeficiencia Humana en Espana,” Enfermedades Infecciosas y Microbiología Clínica, Vol. 28, No. 9, 2010, pp. 583-589. doi:10.1016/j.eimc.2010.02.013

[5]   M. Díez, J. Oliva, A. Díaz, S. Y. Galindo and F. Sánchez, “Epidemiología del Diagnóstico Tardío de la Infección por el VIH-1,” Enfermedades Infecciosas y Microbiología Clínica, Vol. 29, 2011, p. 16.

[6]   J. del Amo, “Estrategias para el Diagnóstico Precoz de la Infección por el VIH-1,” Enf Infecc Microbiol Clin, Vol. 29, 2011, pp. 16-17.

[7]   T. R. Frieden, M. Das-Douglas, S. E. Kellerman and K. J. Hemming, “Applying Public Health Principles to the HIV Epidemic,” The New England Journal of Medicine, Vol. 353, 2005, pp. 2397-2402. doi:10.1056/NEJMsb053133

[8]   S. Moreno, A. Mocroft and D. A. Arminio Monforte, “Medical and Societal Consequences of Late Presentation,” Antiviral Therapy, Vol. 15, No. S1, 2010, pp. 9-15. doi:10.3851/IMP1523

[9]   CDC/MMWR, “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health-Care Setting,” 2006, pp. 1-17.

[10]   WHO, “Recommendations for Surveillance of Transmitted HIV Drug Resistance in Countries Scaling up Antiretroviral Treatment,” Antiviral Therapy, Vol. 13, No. S2, 2008, pp. 25-36.

[11]   J. Castilla, J. Del Romero, V. Hernando, B. Marincovich, S. García and C. Rodriguez, “Effectiveness of Highly Antirretro-Viral Therapy in Reducing Heterosexual Transmission of HIV,” Acquired Immune Deficiency Syndromes, Vol. 40, No. 1, 2005, pp. 96-101. doi:10.1097/01.qai.0000157389.78374.45

[12]   CDC y APTR (Association for Prevention Teaching and Research), “HIV Testing in Emergency Departments: A Practical Guide,” 2010.

[13]   P. G. Choe, W. B. Park, J. S. Song, et al., “Late Presentation of HIV Disease and Its Associated Factors among Newly Diagnosed Patients before and after Abolition of a Government Policy of Mass Mandatory Screening,” Journal of Infection, Vol. 63, 2011, pp. 60-65. doi:10.1016/j.jinf.2011.05.002

[14]   S. Moreno, “Diagnóstico Precoz de la Infección por VIH: Experiencia en Madrid,” Mesa Redonda 7: Estrategias de Diagnóstico Temprano de la Infección por el VIH-1. Enf Infecc Microbiol Clin 2011; 29, Especial Congreso 1 (XV Congreso de la SEIMC), M 07-3, Pág. 17.”

[15]   Y. Yazdanpanh, J. Lange, J. Gerstoft and G. Cairns, “Earling Testing for HIV-How Do We Prevent Late Presentation?” Antiviral Therapy, Vol. 15, No. S1, 2001, pp. 17-24. doi:10.3851/IMP1526

[16]   P. Y. García de Olalla and J. A. Caylá, “Es Posible Disminuir el Retraso Diagnóstico en la Infección del VIH?” Enfermedades Infecciosas y Microbiología Clínica, Vol. 28, No. 9, 2010, pp. 580-582. doi:10.1016/j.eimc.2010.07.004

 
 
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