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Pneumonia patients rarely undergo HIV testing

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SAN DIEGO — New information presented at IDWeek 2015 suggested that despite a high risk for infection, patients admitted to health care facilities with a primary diagnosis of pneumonia are infrequently tested for HIV.

“Bacterial pneumonia has been shown to be a predictor in HIV infection,” Dana Clifton, MD, of Duke University Medical Center, said during a presentation. “Patients of bacterial pneumonia are similar — whether one is HIV positive or negative; it is difficult to decide who we should be screening for HIV.”

Dana Clifton

Clifton and colleagues retrospectively examined a cohort of 6,858 adult pneumonia patients admitted to the Duke University Health System from 1996 through 2014. Enrolled patients (median age, 50 years) were primarily white (53%) or black (41%). Primary outcomes observed by the researchers included documentation of HIV testing within the health system, testing for HIV during pneumonia admission and new diagnosis of HIV infection.

Among this cohort, 5% had previously documented HIV and 0.3% received a positive test for HIV during pneumonia admission. However, 0.7% of pneumonia patients were not tested for HIV and were diagnosed with the infection a median 807 days after initial pneumonia admission.

Analysis of a random sample of patients previously undiagnosed with HIV (n = 207) revealed that 16% received testing throughout their pneumonia admission, and 40% had any HIV test results recorded in the health system. Testing rates throughout the study were largely static, Clifton said, with no change in testing frequency identified before or after 2006 (P > .05).

“We need more studies to look at HIV testing and diagnosis in this high-risk population of patients admitted with pneumonia,” Clifton said. “Opt-out HIV testing among pneumonia patients should be implemented to [increase] earlier HIV diagnosis and improve outcomes.” – by Dave Muoio

Reference:

Clifton D, et al. Abstract 121. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.

Disclosure: The researchers report no relevant financial disclosures.