Retrospective study on the criteria for diagnosis of HIV infection in adults in Zimbabwe.

OBJECTIVE

To review the criteria for diagnosis of HIV infection in adults in order to improve upon the Zimbabwe Adult AIDS case definition.

DESIGN

A descriptive study which involved the analysis of "Request fo r HIV Antibody Test" forms which had been submitted by clinicians to Masvingo Public Health Laboratory, between June 1990 and December 1992.

SETTING

Masvingo Public Health Laboratory, Zimbabwe.

SUBJECTS

627 adult patients.

MAIN OUTCOME MEASURES

HIV seroprevalence; specific, sensitivity and positive predictive values of the Adult AIDS case definition.

RESULTS

The HIV seroprevalence in 627 adult patients whose forms had been submitted to Masvingo Public Health Laboratory was 79pc. The criterion for the diagnosis of HIV infection had a very high specificity value of 93pc but low sensitivity of 53pc. The positive predictive value of the case definition was very high (97pc). The positive predictive values of individual symptoms were calculated and only weight loss and persistent generalized lymphodenopathy had high values of 99pc and 72pc respectively.

CONCLUSIONS

This study has shown that the criterion used in the diagnosis of HIV infection in Zimbabwe is highly specific but relatively insensitive at identifying seropositive patients. This shows the ability of clinicians to identify HIV positive patients irrespective of the stage of the disease (i.e. HIV related symptoms, AIDS related complex or full blown AIDS). There is also a need for constant monitoring of the clinical manifestations of AIDS patients to keep abreast with newer disease manifestations.