Missed opportunities for diagnosing primary HIV infection
Objective:To investigate the extent to which primary HIV infection (PHI) presents to healthcare providers and the degree to which it is unrecognised.Methods:All individuals diagnosed with having recent HIV infection between 2003 and 2005 were identified (based on the following criteria: an evolving...
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| Veröffentlicht in: | Sexually transmitted infections 2008-02, Vol.84 (1), p.14-16 |
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| creator | Sudarshi, D Pao, D Murphy, G Parry, J Dean, G Fisher, M |
| description | Objective:To investigate the extent to which primary HIV infection (PHI) presents to healthcare providers and the degree to which it is unrecognised.Methods:All individuals diagnosed with having recent HIV infection between 2003 and 2005 were identified (based on the following criteria: an evolving antibody response, negative HIV test within 18 months or a serological testing algorithm for recent HIV seroconversion). Symptoms of PHI and previous presentation to other healthcare providers were ascertained from HIV clinic notes and laboratory records (a single laboratory performing all of the HIV tests in the area).Results:Of the 108 subjects, 103 (95%) were male and 93 (86%) were men who had sex with men. A total of 76 of the 108 individuals (70%) reported symptoms of seroconversion. Of these, 40 (53%) presented to a healthcare provider during the symptomatic period. Of these, 21 (52%) were diagnosed with having PHI at first presentation. In the 19 patients (48%) in which a diagnosis of having PHI was not made at first presentation, 15 were seen in primary care, 3 in accident and emergency, and 1 in genitourinary medicine (GUM).Conclusions:The diagnosis of PHI is often missed. Individuals in high-risk groups need to be informed to access healthcare when they experience symptoms of seroconversion. Non-HIV/GUM healthcare providers (especially primary care) may benefit from training in case recognition to improve rates of diagnosis. |
| doi_str_mv | 10.1136/sti.2007.026963 |
| format | Article |
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Symptoms of PHI and previous presentation to other healthcare providers were ascertained from HIV clinic notes and laboratory records (a single laboratory performing all of the HIV tests in the area).Results:Of the 108 subjects, 103 (95%) were male and 93 (86%) were men who had sex with men. A total of 76 of the 108 individuals (70%) reported symptoms of seroconversion. Of these, 40 (53%) presented to a healthcare provider during the symptomatic period. Of these, 21 (52%) were diagnosed with having PHI at first presentation. In the 19 patients (48%) in which a diagnosis of having PHI was not made at first presentation, 15 were seen in primary care, 3 in accident and emergency, and 1 in genitourinary medicine (GUM).Conclusions:The diagnosis of PHI is often missed. Individuals in high-risk groups need to be informed to access healthcare when they experience symptoms of seroconversion. Non-HIV/GUM healthcare providers (especially primary care) may benefit from training in case recognition to improve rates of diagnosis.</description><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sti.2007.026963</identifier><identifier>PMID: 17971369</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Ambulatory Care - standards ; Antigens ; Bacterial infections ; Biological and medical sciences ; Diagnostic Errors ; Early Diagnosis ; Epidemiology. Vaccinations ; Female ; Fever ; General aspects ; Health care ; HIV ; HIV Infections - diagnosis ; Hospitals ; Human immunodeficiency virus ; Human infectious diseases. Experimental studies and models ; Human viral diseases ; Humans ; Illnesses ; Infections ; Infectious diseases ; Laboratories ; Male ; Medical sciences ; Medical tests ; Mortality ; Public health ; Risk Factors ; Sexual Behavior - statistics & numerical data ; Studies ; United Kingdom ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral infections</subject><ispartof>Sexually transmitted infections, 2008-02, Vol.84 (1), p.14-16</ispartof><rights>2008 BMJ Publishing Group</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2008 2008 BMJ Publishing Group</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b498t-5b83f6c51592b941e4aae48c823440b2573ac24c8275fad2ff0d3a263be54d93</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/84/1/14.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/84/1/14.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23552,27903,27904,77346,77377</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19998680$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17971369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sudarshi, D</creatorcontrib><creatorcontrib>Pao, D</creatorcontrib><creatorcontrib>Murphy, G</creatorcontrib><creatorcontrib>Parry, J</creatorcontrib><creatorcontrib>Dean, G</creatorcontrib><creatorcontrib>Fisher, M</creatorcontrib><title>Missed opportunities for diagnosing primary HIV infection</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Objective:To investigate the extent to which primary HIV infection (PHI) presents to healthcare providers and the degree to which it is unrecognised.Methods:All individuals diagnosed with having recent HIV infection between 2003 and 2005 were identified (based on the following criteria: an evolving antibody response, negative HIV test within 18 months or a serological testing algorithm for recent HIV seroconversion). Symptoms of PHI and previous presentation to other healthcare providers were ascertained from HIV clinic notes and laboratory records (a single laboratory performing all of the HIV tests in the area).Results:Of the 108 subjects, 103 (95%) were male and 93 (86%) were men who had sex with men. A total of 76 of the 108 individuals (70%) reported symptoms of seroconversion. Of these, 40 (53%) presented to a healthcare provider during the symptomatic period. Of these, 21 (52%) were diagnosed with having PHI at first presentation. In the 19 patients (48%) in which a diagnosis of having PHI was not made at first presentation, 15 were seen in primary care, 3 in accident and emergency, and 1 in genitourinary medicine (GUM).Conclusions:The diagnosis of PHI is often missed. Individuals in high-risk groups need to be informed to access healthcare when they experience symptoms of seroconversion. Non-HIV/GUM healthcare providers (especially primary care) may benefit from training in case recognition to improve rates of diagnosis.</description><subject>Ambulatory Care - standards</subject><subject>Antigens</subject><subject>Bacterial infections</subject><subject>Biological and medical sciences</subject><subject>Diagnostic Errors</subject><subject>Early Diagnosis</subject><subject>Epidemiology. Vaccinations</subject><subject>Female</subject><subject>Fever</subject><subject>General aspects</subject><subject>Health care</subject><subject>HIV</subject><subject>HIV Infections - diagnosis</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical tests</subject><subject>Mortality</subject><subject>Public health</subject><subject>Risk Factors</subject><subject>Sexual Behavior - statistics & numerical data</subject><subject>Studies</subject><subject>United Kingdom</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral infections</subject><issn>1368-4973</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkMtLAzEQh4Mo1tfZmyyIHoSteWdzlPoEH1BKryG7m5TUdlOTXdD_3pRdFLx4yoT5ZvjNB8ApgmOECL-OrRtjCMUYYi452QEHiAqcE8zJbqoJL3IqBRmBwxiXEEIumNwHIySkSE15AOSLi9HUmd9sfGi7xrXOxMz6kNVOLxofXbPINsGtdfjKHp_mmWusqVrnm2OwZ_UqmpPhPQKz-7vZ5DF_fnt4mtw85yWVRZuzsiCWVwwxiUtJkaFaG1pUBSaUwhIzQXSFafoLZnWNrYU10Sl_aRitJTkCl_3aTfAfnYmtWrtYmdVKN8Z3UQmICSZQ_AtiyCjswfM_4NJ3oUk3KCQKxJMZyhJ13VNV8DEGY9VgQSGotu5Vcq-27lXvPk2cDXu7cm3qX36QnYCLAdCx0isbdFO5-MtJKQtewMTlPediaz5_-jq8Ky6IYOp1PlEQzW6nYnqrtlGver5cL_9N-Q2oqqbm</recordid><startdate>200802</startdate><enddate>200802</enddate><creator>Sudarshi, D</creator><creator>Pao, D</creator><creator>Murphy, G</creator><creator>Parry, J</creator><creator>Dean, G</creator><creator>Fisher, M</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200802</creationdate><title>Missed opportunities for diagnosing primary HIV infection</title><author>Sudarshi, D ; Pao, D ; Murphy, G ; Parry, J ; Dean, G ; Fisher, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b498t-5b83f6c51592b941e4aae48c823440b2573ac24c8275fad2ff0d3a263be54d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Ambulatory Care - standards</topic><topic>Antigens</topic><topic>Bacterial infections</topic><topic>Biological and medical sciences</topic><topic>Diagnostic Errors</topic><topic>Early Diagnosis</topic><topic>Epidemiology. Vaccinations</topic><topic>Female</topic><topic>Fever</topic><topic>General aspects</topic><topic>Health care</topic><topic>HIV</topic><topic>HIV Infections - diagnosis</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical tests</topic><topic>Mortality</topic><topic>Public health</topic><topic>Risk Factors</topic><topic>Sexual Behavior - statistics & numerical data</topic><topic>Studies</topic><topic>United Kingdom</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sudarshi, D</creatorcontrib><creatorcontrib>Pao, D</creatorcontrib><creatorcontrib>Murphy, G</creatorcontrib><creatorcontrib>Parry, J</creatorcontrib><creatorcontrib>Dean, G</creatorcontrib><creatorcontrib>Fisher, M</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sudarshi, D</au><au>Pao, D</au><au>Murphy, G</au><au>Parry, J</au><au>Dean, G</au><au>Fisher, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Missed opportunities for diagnosing primary HIV infection</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2008-02</date><risdate>2008</risdate><volume>84</volume><issue>1</issue><spage>14</spage><epage>16</epage><pages>14-16</pages><issn>1368-4973</issn><eissn>1472-3263</eissn><abstract>Objective:To investigate the extent to which primary HIV infection (PHI) presents to healthcare providers and the degree to which it is unrecognised.Methods:All individuals diagnosed with having recent HIV infection between 2003 and 2005 were identified (based on the following criteria: an evolving antibody response, negative HIV test within 18 months or a serological testing algorithm for recent HIV seroconversion). Symptoms of PHI and previous presentation to other healthcare providers were ascertained from HIV clinic notes and laboratory records (a single laboratory performing all of the HIV tests in the area).Results:Of the 108 subjects, 103 (95%) were male and 93 (86%) were men who had sex with men. A total of 76 of the 108 individuals (70%) reported symptoms of seroconversion. Of these, 40 (53%) presented to a healthcare provider during the symptomatic period. Of these, 21 (52%) were diagnosed with having PHI at first presentation. In the 19 patients (48%) in which a diagnosis of having PHI was not made at first presentation, 15 were seen in primary care, 3 in accident and emergency, and 1 in genitourinary medicine (GUM).Conclusions:The diagnosis of PHI is often missed. Individuals in high-risk groups need to be informed to access healthcare when they experience symptoms of seroconversion. Non-HIV/GUM healthcare providers (especially primary care) may benefit from training in case recognition to improve rates of diagnosis.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17971369</pmid><doi>10.1136/sti.2007.026963</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Sexually transmitted infections, 2008-02, Vol.84 (1), p.14-16 |
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| subjects | Ambulatory Care - standards Antigens Bacterial infections Biological and medical sciences Diagnostic Errors Early Diagnosis Epidemiology. Vaccinations Female Fever General aspects Health care HIV HIV Infections - diagnosis Hospitals Human immunodeficiency virus Human infectious diseases. Experimental studies and models Human viral diseases Humans Illnesses Infections Infectious diseases Laboratories Male Medical sciences Medical tests Mortality Public health Risk Factors Sexual Behavior - statistics & numerical data Studies United Kingdom Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral infections |
| title | Missed opportunities for diagnosing primary HIV infection |
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