Rationales for indicator condition-based HIV testing data from the Hospital for Infectious Diseases in Warsaw – one-year observation

Introduction: The European study HIDES (HIV Indicator Disease Across Europe Study) has shown that indicator condition (IC)-based HIV testing may increase the number of detected HIV infections among patients with a given medical conditions. Currently routine HIV testing for IC is not covered by public healthcare in Poland, which may delay or miss the opportunity for HIV diagnosis. The aim of the study was to evaluate HIV testing patterns among patients presenting with specific IC-ongoing mononucleosis-like illness (mononucleosis) in emergency departments (ED).

Material and methods: We performed retrospective analysis of patients with mononucleosis referred from ED to hospital departments for further diagnostics within the past 12 months.

Results: In total 173 patients were consulted in ED with mononucleosis, that is 94 men and 79 women, with median age of 26 years. Seventy-two (41.6%) patients were admitted to hospital, among whom 54 (75%) were offered an HIV test and all expressed consent. Four patients (5.5%) were diagnosed with HIV, referred to an HIV clinic, and linked to care. According to analyses, 68% of patients missed the opportunity for HIV testing, 58% in ED due to lack of such healthcare program, and 10% of unknown reason. With the presented rate, this translated to eight HIV patients who may still remain unaware of HIV infection.

Conclusions: The rate of HIV diagnosis among patients hospitalised due to mononucleosis was high, confirming the benefit of routine testing of this group of patients. Standards of care for mononucleo­sis should include routine HIV testing, which needs additional financing and attention from public healthcare representatives and other stakeholders.