Ramping up HIV screening programs in hospitals detects more people who have lived with HIV for a period long enough to deplete their immune systems as well as acute cases of the virus, aidsmap reports. Results from a pilot project examining the effects of expanded testing in British Columbia between October 2011 and June 2013 were presented at the 2014 Treatment as Prevention Workshop in Vancouver.
Three B.C. hospitals participating in the program instituted a policy of routinely testing patients, as did 500 participating primary care physicians. During the final six months of the study period, 73,000 HIV tests were performed in all participating settings, compared with just 38,000 tests during any six-month period from 2008 to 2010.
The hospitals detected 30 HIV cases in 2012 and 27 in 2013, with each sum more than twice the 11 cases found in 2010. Primary care offices did not see an increase, likely because the prevalence of HIV in those settings is about the same as the population at large, whereas the prevalence in a hospital setting is more than double the province-wide figure.
Forty-four percent of hospital patients were offered a test, with 36 percent receiving one.
Thirty-five percent of those testing positive in a hospital had a CD4 count below 200, making them “late presenters,” or those who have been living with HIV for a considerable amount of time without knowing it. Meanwhile, just 12 percent of those tested in other centers were late presenters. Twenty-five percent of the newly identified cases of HIV in hospitals were acute, or very recent, cases of the virus, compared with 15 percent elsewhere.
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