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Jordans CC, Vasylyev M, Rae C, Jakobsen ML, Vassilenko A, Dauby N, Grevsen AL, Jakobsen SF, Raahauge A, Champenois K, Papot E, Malin JJ, Boender TS, Behrens GM, Gruell H, Neumann A, Spinner CD, Valbert F, Akinosoglou K, Kostaki EG, Nozza S, Giacomelli A, Lapadula G, Mazzitelli M, Torti C, Matulionyte R, Matulyte E, Van Welzen BJ, Hensley KS, Thompson M, Ankiersztejn-Bartczak M, Skrzat-Klapaczyńska A, Săndulescu O, Streinu-Cercel A, Streinu-Cercel A, Miron VD, Pokrovskaya A, Hachfeld A, Dorokhina A, Sukach M, Lord E, Sullivan AK, Rokx C. National medical specialty guidelines of HIV indicator conditions in Europe lack adequate HIV testing recommendations: a systematic guideline review. Euro Surveill 2022; 27:2200338. [PMID: 36695464 PMCID: PMC9716648 DOI: 10.2807/1560-7917.es.2022.27.48.2200338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BackgroundAdequate identification and testing of people at risk for HIV is fundamental for the HIV care continuum. A key strategy to improve timely testing is HIV indicator condition (IC) guided testing.AimTo evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in European countries.MethodsBetween 2019 and 2021, European HIV experts reviewed guideline databases to identify all national guidelines of 62 HIV ICs. The proportion of HIV IC guidelines recommending HIV testing was reported, stratified by subgroup (HIV IC, country, eastern/western Europe, achievement of 90-90-90 goals and medical specialty).ResultsOf 30 invited European countries, 15 participated. A total of 791 HIV IC guidelines were identified: median 47 (IQR: 38-68) per country. Association with HIV was reported in 69% (545/791) of the guidelines, and 46% (366/791) recommended HIV testing, while 42% (101/242) of the AIDS-defining conditions recommended HIV testing. HIV testing recommendations were observed more frequently in guidelines in eastern (53%) than western (42%) European countries and in countries yet to achieve the 90-90-90 goals (52%) compared to those that had (38%). The medical specialties internal medicine, neurology/neurosurgery, ophthalmology, pulmonology and gynaecology/obstetrics had an HIV testing recommendation uptake below the 46% average. None of the 62 HIV ICs, countries or medical specialties had 100% accurate testing recommendation coverage in all their available HIV IC guidelines.ConclusionFewer than half the HIV IC guidelines recommended HIV testing. This signals an insufficient adoption of this recommendation in non-HIV specialty guidelines across Europe.
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Affiliation(s)
- Carlijn C.E. Jordans
- Erasmus University Medical Center, Department of Internal Medicine and Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
| | | | - Caroline Rae
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Marie Louise Jakobsen
- Centre of Excellence for Health, Immunity & Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna Vassilenko
- Republican Scientific and Practical Center of Medical Technologies, Informatization, Management and Economics of Public Health, Minsk, Belarus
| | - Nicolas Dauby
- CHU Saint-Pierre, Université Libre de Bruxelles (ULB), and School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anne Louise Grevsen
- Centre of Excellence for Health, Immunity & Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stine Finne Jakobsen
- Centre of Excellence for Health, Immunity & Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Raahauge
- Centre of Excellence for Health, Immunity & Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Jakob J. Malin
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Division of Infectious Diseases, Cologne, Germany
| | - T. Sonia Boender
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany,ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Georg M.N Behrens
- Hannover Medical School, Department for Rheumatology and Immunology, Hannover, Germany
| | - Henning Gruell
- Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Christoph D. Spinner
- Technical University of Munich, School of Medicine, University hospital rechts der Isar, Department of Internal Medicine II, Munich, Germany
| | - Frederik Valbert
- Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Karolina Akinosoglou
- Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Patras, Greece
| | - Evangelia G. Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Andrea Giacomelli
- III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Via G.B. Grassi, Milan, Italy
| | - Giuseppe Lapadula
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Mazzitelli
- Magna Graecia University of Cantanzaro, Catanzaro, Italy,Infectious and Tropical Diseases Unit, University Hospital, Padua, Italy
| | - Carlo Torti
- University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Raimonda Matulionyte
- Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Elzbieta Matulyte
- Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Berend J. Van Welzen
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kathryn S. Hensley
- Erasmus University Medical Center, Department of Internal Medicine and Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
| | | | | | - Agata Skrzat-Klapaczyńska
- Hospital for Infectious Diseases Warsaw, Medical University of Warsaw, Department of Adults’ Infectious Diseases, Warsaw, Poland
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,National Institute for Infectious Diseases “Prof.Dr. Matei Bals”, Bucharest, Romania
| | - Adrian Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,National Institute for Infectious Diseases “Prof.Dr. Matei Bals”, Bucharest, Romania
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,National Institute for Infectious Diseases “Prof.Dr. Matei Bals”, Bucharest, Romania
| | | | - Anastasia Pokrovskaya
- Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russian Federation
| | - Anna Hachfeld
- Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Antonina Dorokhina
- National Children's Specialized Hospital “OKHMATDYT” of Ministry of Health of Ukraine, Kyiv, Ukraine,O.O.Bogomolets’ National Medical University, Kyiv, Ukraine
| | - Maryna Sukach
- O.O.Bogomolets’ National Medical University, Kyiv, Ukraine
| | - Emily Lord
- Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Ann K. Sullivan
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Casper Rokx
- Erasmus University Medical Center, Department of Internal Medicine and Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
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