Ouladlahsen A, Bensghir R, Karkouri M, Elharti E, Oumzil H, Himmich H, Elfilali K M, Chakib A
Service des maladies infectieuses, CHU d'Ibn Rochd, Casablanca, Maroc.
Rev Epidemiol Sante Publique. 2012 Aug;60(4):333-8. doi: 10.1016/j.respe.2012.01.009. Epub 2012 Jul 11.
In Morocco, diagnosis of HIV infection remains late, which seriously compromises the timely management of HIV infection in the era of HAART therapies. Rapid test represents a good opportunity to improve the access to early screening of HIV. The objective of this study is to report the experience of the infectious diseases unit of the Ibn Rochd University hospital center of Casablanca, in the use of the rapid test in clinical screening of HIV.
This retrospective study reports data relevant to the use of the rapid test Determine VIH-1/2, Abbott Diagnostics, since its introduction in the infectious diseases unit in April 2006 up to December 2009. The test was performed for patients from the infectious diseases unit and patients hospitalized in different units of the Ibn Rochd University hospital center, after their consent. Test was ordered systematically by clinicians in case of any suspected symptom related to HIV and immunodepression. Positive samples were confirmed by Western Blot test, at the National Reference Laboratory for HIV, within the Institut National d'Hygiène in Rabat.
Between 2006 and 2009, 1105 rapid tests were performed, among which 16.3% were positive. All results were provided to patients and none were lost to follow-up. The main reasons for the prescription of an HIV test were tuberculosis (26.3%) and chronic diarrhea (9.9%) for inpatients. For outpatients, the main symptoms were sexually transmissible infections (16.7%) and weight loss (15.7%). Results of the tests allowed us to adapt the treatment in case of suspicion of pneumocystosis (12 cases) and toxoplasmosis (seven cases).
The introduction of the rapid test for HIV clinical screening in the hospital facilities improved considerably the access to diagnosis and consequently allowed a timely management of HIV infection.
在摩洛哥,HIV感染的诊断仍然较晚,这在高效抗逆转录病毒治疗(HAART)时代严重影响了HIV感染的及时管理。快速检测为改善HIV早期筛查的可及性提供了一个良好契机。本研究的目的是报告卡萨布兰卡伊本·鲁世德大学医院中心传染病科在临床筛查HIV中使用快速检测的经验。
这项回顾性研究报告了自2006年4月快速检测试剂Determine VIH-1/2(雅培诊断公司)引入传染病科至2009年12月期间相关的数据。该检测在获得患者同意后,针对传染病科患者以及伊本·鲁世德大学医院中心不同科室住院的患者进行。临床医生在出现任何与HIV和免疫抑制相关的可疑症状时会系统性地开出检测医嘱。阳性样本在拉巴特国家卫生研究所的国家HIV参考实验室通过蛋白免疫印迹试验进行确认。
2006年至2009年期间,共进行了1105次快速检测,其中16.3%为阳性。所有检测结果都告知了患者,无一失访。住院患者进行HIV检测的主要原因是肺结核(26.3%)和慢性腹泻(9.9%)。门诊患者的主要症状是性传播感染(16.7%)和体重减轻(15.7%)。检测结果使我们能够在怀疑有肺孢子菌病(12例)和弓形虫病(7例)时调整治疗方案。
在医院设施中引入HIV临床筛查快速检测显著改善了诊断的可及性,从而能够及时管理HIV感染。