García-Ruiz de Morales Alejandro G, Vivancos María Jesús, Lázaro Jorge, Romero Hernández Beatriz, Mateos Beatriz, Pérez-Elías Pilar, Herrero Delgado Margarita, Villanova Cuadra Laura, Moreno Santiago, Martínez-Sanz Javier, Pérez-Elías María Jesús
Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, Spain.
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Biomedicines. 2024 Aug 14;12(8):1846. doi: 10.3390/biomedicines12081846.
Despite remarkable improvement in the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) care continuum, the rate of late diagnosis of HIV and HCV in high-income countries remains unacceptably high. Testing relies mainly on primary care physicians' identification of risk factors. We aimed to adapt an analogic to an online questionnaire to help HIV and HCV screening and perform a pilot study to assess its accuracy and acceptability. We used the Delphi method to adapt a previously validated analogical questionnaire to a user-friendly online tool. It aimed to identify participants who should be screened for HIV or HCV and those who should be referred for pre-exposure prophylaxis (PrEP). We then designed a proof-of-concept pilot study from July to October 2022 to test its feasibility and suitability for use on a larger scale and to assess its accuracy in identifying patients at risk for HIV or HCV or with indication for PrEP. The final questionnaire consisted of 37 questions. A total of 142 participants provided informed consent, and 102 completed the questionnaire: 41 random patients recruited at the primary care level, 10 participants recently diagnosed with HIV, 20 participants with HIV on follow-up, 21 participants from the PrEP program, and 10 patients diagnosed with HCV. The tool adequately indicated the need for testing in more than 98% of participants with confirmed HIV/HCV infections or in the PrEP program. Furthermore, it adequately assessed PrEP referral in 94% of participants already on PrEP or with known HIV infection. Participants were highly satisfied with the tool, and 98% of them recommended its use. A self-administered web-based tool to identify patients who should be tested for HIV or HCV or referred to PrEP could simplify patient selection and help reduce late diagnosis.
尽管在人类免疫缺陷病毒(HIV)和丙型肝炎病毒(HCV)护理连续体方面取得了显著进展,但高收入国家中HIV和HCV的晚期诊断率仍然高得令人无法接受。检测主要依赖于初级保健医生对风险因素的识别。我们旨在将一份类似物改编为在线问卷,以帮助进行HIV和HCV筛查,并开展一项试点研究来评估其准确性和可接受性。我们使用德尔菲法将一份先前经过验证的类似问卷改编为用户友好的在线工具。该工具旨在识别应接受HIV或HCV筛查的参与者以及应被转介接受暴露前预防(PrEP)的参与者。然后,我们在2022年7月至10月设计了一项概念验证试点研究,以测试其在更大规模上使用的可行性和适用性,并评估其在识别有HIV或HCV风险或有PrEP指征的患者方面的准确性。最终问卷包含37个问题。共有142名参与者提供了知情同意,102人完成了问卷:41名在初级保健层面招募的随机患者、10名最近被诊断出感染HIV的参与者、20名接受随访的HIV感染者、21名来自PrEP项目的参与者以及10名被诊断出感染HCV的患者。该工具在超过98%确诊感染HIV/HCV的参与者或PrEP项目参与者中充分表明了检测的必要性。此外,它在94%已经接受PrEP或已知感染HIV的参与者中充分评估了PrEP转介情况。参与者对该工具高度满意,98%的人推荐使用它。一种用于识别应接受HIV或HCV检测或转介接受PrEP的患者的自我管理网络工具可以简化患者选择,并有助于减少晚期诊断。