Clifton Dana C, Clement Meredith E, Holland Thomas L, Cox Gary M, Dicks Kristen V, Stout Jason E
Departments of Medicine and Pediatrics, Division of General Internal Medicine, Section of Hospital Medicine, Duke University School of Medicine, Durham, North Carolina.
Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine.
AIDS Educ Prev. 2017 Aug;29(4):377-388. doi: 10.1521/aeap.2017.29.4.377.
Patients admitted with pneumonia are at higher risk for HIV and should be routinely screened. We examined a retrospective cohort of patients admitted to Duke University Health System with a primary diagnosis of pneumonia. During the study period, 6,951 persons were admitted with pneumonia. Of 6,646 patients without a known prior diagnosis of HIV, 1,010 (15%) had HIV testing during admission and 1,516 (23%) had a previously documented HIV test result. Forty-one (0.6%) patients had a positive HIV test during admission and 27 (0.4%) patients were diagnosed with HIV a median of 498 (IQR 112-982) days later, with median CD4 count of 64 (IQR 16-281) cells/mm. HIV testing rates remain low in a population at high risk for HIV. At a minimum, we should be adhering to universal HIV screening recommendations, and certainly we should be screening those at higher risk. Opt-out HIV testing of pneumonia inpatients should be implemented.
因肺炎入院的患者感染艾滋病毒的风险更高，应进行常规筛查。我们对杜克大学健康系统收治的以肺炎为主要诊断的患者进行了一项回顾性队列研究。在研究期间，6951人因肺炎入院。在6646名之前无已知艾滋病毒诊断的患者中，1010人（15%）在入院期间进行了艾滋病毒检测，1516人（23%）有先前记录的艾滋病毒检测结果。41名（0.6%）患者在入院期间艾滋病毒检测呈阳性，27名（0.4%）患者在中位时间498天（四分位间距112 - 982天）后被诊断为艾滋病毒感染，中位CD4细胞计数为64个/立方毫米（四分位间距16 - 281个）。在艾滋病毒高风险人群中，艾滋病毒检测率仍然很低。至少，我们应该遵循普遍的艾滋病毒筛查建议，当然我们应该对高风险人群进行筛查。应实施对肺炎住院患者的不反对艾滋病毒检测。
