Assessing the predictive value of HIV indicator conditions in general practice:-a case-control study using the THIN database

摘要

Up to one-third of new HIV patients may have had multiple primary care consultations before diagnosis with symptoms that were, in hindsight, related to HIV infection. National HIV guidelines identify 37 clinical indicator conditions that should prompt an HIV test (Box 1), yet few data currently exist to show the predictive value of these conditions in indicating undiagnosed HIV. A predictive tool, based on patient presentation in primary care with any of the 37 indicator conditions, could facilitate targeted HIV testing in primary care settings where such tests are not routinely offered, but where patients presenting with one or more indicator conditions are regularly encountered. This study used The Health Improvement Network (THIN) database to identify symptoms and clinical diagnoses associated with HIV infection, and assessed their relative importance in identifying HIV cases.