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首页> 外文期刊>BMC Family Practice >The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care
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The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care

机译：为了早期发现病例，有必要扩大艾滋病毒指示剂条件指导的检测：初级保健中的病例对照研究

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Background European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis. Methods We did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis. Results We included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds ( n =?136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% ( n =?411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy. Conclusions Our study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs’ future guidelines and that education strategies be used to facilitate its implementation in daily practice.
机译：背景技术欧洲指南建议为显示HIV指标状况（ICs）的个人提供HIV测试。我们旨在调查在HIV诊断之前病历中报告的初级保健中ICs的发生率。方法我们使用匹配的病例对照设计方法在电子全科医学数据库中进行横断面搜索，以确定在诊断之前由荷兰全科医生注册的哪些预定义IC与HIV阳性状态最相关。结果我们纳入了2009年至2013年确诊的224例HIV感染病例，并与2,193例对照相匹配。在索引日期之前的五年内，将近三分之二（n = 136，60.7％）的病例被诊断为具有一个或多个ICs，而对照组为18.7％（n = 411）。与对照相比，病例更有可能具有IC：在下标日期之前的一年中，至少一种情况的赔率（OR）是11.7（95％CI：8.3 to 16.4）。比较性别，年龄组或城市化水平时，HIV诊断与IC之间的关联强度没有显着差异。没有迹象表明子组需要不同的测试策略。结论我们的研究表明，在初级保健中存在IC引导测试的机会。我们建议将IC引导的测试更多地整合到GP的未来指南中，并建议采用教育策略来促进其在日常实践中的实施。

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