Acquah R R, Baggott A, McGoldrick C, Kennedy N
RR Acquah, Brownlee Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G14 0YN, UK. Email
J R Coll Physicians Edinb. 2014;44(4):278-82. doi: 10.4997/JRCPE.2014.405.
The 2008 UK National Guidelines for HIV testing were designed in order to decrease the proportion of people living with undiagnosed HIV infection.
Two audits were conducted. The aim of Audit 1 was to determine the proportion of current medical inpatients with an indicator condition that had been tested for HIV. Audit 2 aimed to identify missed opportunities for testing prior to diagnosis among newly diagnosed individuals with HIV.
Audit 1 involved a case note review looking for indicator conditions and HIV testing of all inpatients. Audit 2 analysed the hospital case notes of all new Lanarkshire HIV patients in 2010 for previous missed diagnostic opportunities.
In Audit 1, 36% (63/174) of medical inpatients had a current indicator condition. Of the total population, 1.7% (3/174) had what would be an AIDS-defining condition if they had a positive HIV test. However, only 11% (7/63) of individuals were appropriately HIV tested. For Audit 2, 64% (9/14) of newly diagnosed individuals had previous missed opportunities for diagnosis.
Increased education of clinical staff around testing guidelines is needed, as we have demonstrated that the 2008 guidelines are not being adhered to.
2008年英国国家艾滋病病毒检测指南旨在降低未被诊断出感染艾滋病病毒的人群比例。
进行了两项审计。审计1的目的是确定患有指标性疾病的当前住院患者中接受过艾滋病病毒检测的比例。审计2旨在识别新诊断出的艾滋病病毒感染者在诊断前错过的检测机会。
审计1包括对所有住院患者的病历进行回顾，查找指标性疾病和艾滋病病毒检测情况。审计2分析了2010年拉纳克郡所有新确诊艾滋病病毒患者的医院病历，以查找之前错过的诊断机会。
在审计1中，36%（63/174）的住院患者患有当前指标性疾病。在总人群中，1.7%（3/174）的人若艾滋病病毒检测呈阳性将患有艾滋病界定疾病。然而，只有11%（7/63）的人接受了适当的艾滋病病毒检测。对于审计2，64%（9/14）的新确诊患者之前存在错过诊断的机会。
需要加强对临床工作人员关于检测指南的教育，因为我们已证明2008年指南未得到遵守。
