• Antiretroviral therapy (ART) has transformed treatment of HIV infection • The benefits of early diagnosis of HIV are well recognised - not offering HIV testing represents a missed opportunity • Over 25% of HIV-positive individuals remain undiagnosed, accounting for 54-70% of transmission • 39% of HIV-positive heterosexuals are not diagnosed until their CD4 cell count falls below 200 • In 2005, 24% of deaths in HIV-positive adults were attributable to late HIV diagnosis • In one study, 62% of late diagnoses had been seen in secondary care in the previous 2 years, 26% with an HIV related problem Key messages
Transcript
• Antiretroviral therapy (ART) has transformed treatment of HIV infection
• The benefits of early diagnosis of HIV are well recognised - not offering HIV testing represents a missed opportunity
• Over 25% of HIV-positive individuals remain undiagnosed, accounting for 54-70% of transmission
• 39% of HIV-positive heterosexuals are not diagnosed until their CD4 cell count falls below 200
• In 2005, 24% of deaths in HIV-positive adults were attributable to late HIV diagnosis
• In one study, 62% of late diagnoses had been seen in secondary care in the previous 2 years, 26% with an HIV related problem
Key messages
• UK recommend screening for HIV in adult populations where undiagnosed prevalence is >1/1000 as it has been shown to be cost-effective
• UK guidelines recommend routine opt-out HIV testing for patients with <insert relevant condition>
• UK guidelines recommend universal HIV testing for patients from groups at higher risk of HIV infection
• A perceived lack of risk should not deter you from offering a test when clinically indicated
• Some patients may not disclose that they have put themselves at risk of HIV infection in the past
Key messages
Tackling HIV TestingProject Advisory Group
Dr Mary Armitage (Chair), Immediate Past Clinical Vice-President, Royal College of Physicians,Consultant Physician & Endocrinologist, Royal Bournemouth Hospital
Dr Nick Beeching, Clinical Lead, Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital
Dr Christine Blanshard, Consultant Physician and Gastroenterologist, Homerton Hospital, London
Dr Gary Brook, Consultant in Genitourinary Medicine, Central Middlesex Hospital, London
Professor Chris Bunker, Consultant Dermatologist, Chelsea & Westminster and Royal Marsden Hospitals, Imperial College London
Professor Jackie Cassell, Chair in Clinical Epidemiology, Brighton and Sussex Medical School
Dr Martin Fisher, Consultant in HIV/Genitourinary Medicine, Brighton and Sussex University Hospital
Dr Susie Forster, Consultant in Genitourinary Medicine and Clinical Lead for Sexual Health, Cambridgeshire Community Services
Professor Margaret Johnson, Professor of HIV Medicine, Royal Free Hospital, London
Ms Ruth Lowbury, Chief Executive, MedFASH
Professor Rob Miller, Consultant Physician and Reader in Clinical Infection, University College Hospital, London
Ms Angelina Namiba, Project Manager, Primary Care Access, Positively Women
Mr Charles Oduka, Chair, African HIV Policy Network
Dr Ed Ong, Consultant in Infectious Diseases, Newcastle General Hospital
Ms Kay Orton, Policy Lead for HIV Services, Department of Health
Dr Adrian Palfreeman, Consultant in Genitourinary Medicine, Leicester Royal Infirmary
Dr Angela Robinson, Consultant in Genitourinary Medicine, University College Hospital, London
Dr Murad Ruf, Assistant Director Health Protection, Consultant in Public Health Medicine, NHS Lambeth
Ms Heather Wilson, Senior Health Adviser, Barnet Hospital, London
Tackling HIV TestingProject Contributors
MedFASH is grateful to the following colleagues who contributed cases and materials to the project:
Dr Rachel Baggaley, Dr Rachel Baggaley, Head of HIV and Health at Christian Aid, Honorary Research Fellow at the London School of Hygiene and Tropical Medicine and working in primary health care in Lambeth PCT
Dr Nick Beeching, Clinical Lead, Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital
Dr Christine Blanshard, Consultant Physician and Gastroenterologist, Homerton Hospital, London
Dr Gary Brook, Consultant in Genitourinary Medicine, Central Middlesex Hospital, London
Professor Chris Bunker, Consultant Dermatologist, Chelsea & Westminster and Royal Marsden Hospitals, Imperial College, London
Dr Kate Cwynarski, Consultant Haematologist, Royal Free Hospital, London
Dr Martin Fisher, Consultant in HIV/Genitourinary Medicine, Brighton and Sussex University Hospital
Dr Susie Forster, Consultant in GUM and Clinical Lead for Sexual Health, Cambridgeshire Community Services
Professor Rob Miller, Consultant Physician and Reader in Clinical Infection, University College Hospital, London
Dr Adrian Palfreeman, Consultant in Genitourinary Medicine, Leicester Royal Infirmary
Dr Conal Perrett, Dermatology Department, Chelsea & Westminster Hospital, London
Dr Alison Rodger, Department of Infection and Population Health, University College London and HIV Department, Royal Free Hospital, London
