Sharvill Rory, Fernandes Arnold, Allen Kate, Astin Jeremy
Royal United Hospital, Bath, UK.
Int J STD AIDS. 2017 Jan;28(1):88-90. doi: 10.1177/0956462416675108. Epub 2016 Oct 23.
Early identification of HIV infection is of obvious benefit to patients' health, yet many remain unaware of their diagnosis, with detrimental consequences. Current guidelines suggest patients with pneumonia are offered an HIV test. Early diagnosis of HIV infection in critically ill patients within intensive care is vital in reducing mortality and morbidity. In 2015, we established automated HIV testing for patients with pneumonia admitted to our intensive care unit. Prior to our change in practice, our HIV testing rate in patients with pneumonia was 29% within two weeks of admission. After implementation, 80% of patients with pneumonia were tested for HIV within 48 h (73% with 24 h). This intervention also facilitated an early and unexpected HIV diagnosis in one patient, which then allowed prompt tailored therapy and was a significant factor in their survival. Based on our success, we suggest other centres may benefit from employing a similar automated HIV testing system, especially in targeted patient groups such as severe pneumonia.
早期识别艾滋病毒感染对患者健康有明显益处，但许多患者仍未意识到自己的诊断结果，从而产生有害后果。当前指南建议对肺炎患者进行艾滋病毒检测。在重症监护病房对危重症患者进行艾滋病毒感染的早期诊断对于降低死亡率和发病率至关重要。2015年，我们为入住重症监护病房的肺炎患者建立了艾滋病毒自动检测机制。在我们改变做法之前，肺炎患者在入院两周内的艾滋病毒检测率为29%。实施该机制后，80%的肺炎患者在48小时内接受了艾滋病毒检测（73%在24小时内）。这一干预措施还促使对一名患者进行了早期且意外的艾滋病毒诊断，从而能够迅速进行针对性治疗，这是其存活的一个重要因素。基于我们的成功经验，我们建议其他中心可能会从采用类似的艾滋病毒自动检测系统中受益，尤其是在严重肺炎等特定患者群体中。
