HIV Testing patterns and missed opportunities for diagnosis
|
|
- Samson Fitzgerald
- 6 years ago
- Views:
Transcription
1 HIV Testing patterns and missed opportunities for diagnosis P. Read, D. Armstrong-James, W. Tong, J. Fox Background 2008 National guidelines published to increase HIV testing to reduce undiagnosed infection Onward transmission Late stage diagnosis (CD4<200) Associated with high mortality (BHIVA Audit 2007) Accounts for 40% new diagnoses Guys and St Thomas Guidelines recommend Increased HIV testing in non-gum settings A lot of focus on community and A&E HIV test those with HIV indicator conditions
2 Objectives Describe HIV testing practices Guys and St Thomas Hospital pre-implementation of guidelines For HIV positive tests: explored missed opportunities for HIV testing investigated whether National guidelines would have led to earlier diagnosis
3 Method All HIV tests performed at Guys and St Thomas lab in 2008 Case note review of HIV-positive results: Previous presentations to Guys and St Thomas Evidence of HIV indicator diseases Tests from known HIV positives excluded Results : location of HIV Testing HIV tests performed on individuals 363 HIV positive results (1% detection rate) Location No. tests No. positives % positive GUM % Antenatal % GP (cannot excl antenatal) % Outpatients (excl Harrison wing) % Occ. Health % Inpatients % Family planning % HIV screening is cost effective where prevalence > 0.05 per cent (Sanders NEJM 2005)
4 Request form reviewed GP diagnoses n=68 N=28 no details on form 23/40 (58%) screening 13 sexual health screen 4 IDU 4 antenatal 1 Needlestick 17/40 (43%) indicator diseases 5 Haematological Neutropenia Thrombocytopenia Lymphopenia 3 possible seroconversion 3 Lymphadenopathy 4 viral hepatitis B or C 1 Weight loss 1 Herpes Zoster 1 Chronic diarrhoea I.e. GPS are thinking of HIV and indicator disease Outpatient HIV tests 26/5303 (0.5%) positive Reason for test not explored Team No Tests No. pos Fertility ENT 27 4 Drug team n/a 4 Gynae Haem Chest 99 3 Renal Rheum 30 1 Police n/a 1 Mental Health n/a 1 Team No Tests No. pos A&E Derm 88 0 Gastro 83 0 Oncology 54 0 Endocrine 23 0 Ophthal 22 0 Urology 16 0 Neurology 15 0 Cardiology 7 0 Other 507 0
5 New HIV positive -outpatients 8 infections not new diagnoses 7/ 17 (41%) attended Guys and St Thomas in past yr All had indicator diseases: All had lymphopenia (mean CD4 190) TB Persistent CIN 2 Generalized Molluscum Severe psoriasis Recurrent bacterial chest infections I.e. missed opportunity Do patients get HIV result? 1/26 not documented received diagnosis A&E: patient had been contacted by phone and was seeking care elsewhere.
6 Inpatient diagnoses n=34 Total notes reviewed 29 Age median (Range) 43 ( 21-74) Risk group 15 (51%) Heterosexual (12 BA,3 BC) - 12 (41%) women - 3 (10%) men 11 MSM (38%)( 100% Caucasian) 2 IDU (7%) CD4 count Median 64 (Range 4-760) Stage of HIV infection: AIDS defining Symptomatic HIV disease Asymptomatic (from HIV) Seroconversion illness 18/29 (62%) 6/29 3/29 2 Admission duration mean 34 days (Range 0-324) 69 days in ITU/HDU Cost of admission mean 36,625 (Range 3, k) Time admission to test mean 2.31 days (0-14 days) Previous attendances of inpatient diagnoses 12/29 (41%) had previous GSTT attendance in past year 10/12 (83%) had HIV indicator conditions in previous visits Pneumonia, Ca Cervix, lymphopaenia Lymphopaenia (Raised TP, Fe-anaemia) Lymphopaenia (Fe-anemia, multiple abscesses) Pneumonia Pneumonia & Lymphopaenia VZV and aggressive HPV VAIN/CIN CIN III Neutropaenia & dementia Hep C, weight loss, psychosis
7 Conclusions Low number of tests in outpatient settings high detection rate Suggests more tests may detect more infection testing due to indicator diseases not assessed Opportunities for earlier diagnoses identified 41% inpatient and 41% outpatient diagnoses had attended GSTT in past year most had retrospective evidence of HIV indicator disease In and out patient diagnoses were late stage In patients had multiple pathologies, long admissions Diagnosis occurred early in admission Long expensive admissions are often avoidable Recommendations Findings support urgent implementation of National guidelines Wider hospital audience needs to be involved Missed opportunity for testing = governance issue Trust governance committee Lambeth PCT preventing late diagnosis key priority Promoted HIV indicator diseases to rest of hospital Other possibilities: laboratory or radiology reports with indicator conditions to suggest an HIV test haematology reports to provide local HIV prevalence In order for roll out to be a successall positive results must be acted upon and documented
8 Acknowledgements GUM & HIV: P. Read Virology: D. Armstrong-James W. Tong Lambeth PCT: M Ruf
Protocol for HIV testing of adults outside the HIV specialist setting
TEMPLATE A page 1 Protocol for testing of adults outside the specialist setting Introduction In September 2007 the Chief Medical Officer and Chief Nursing Officer sent out a Dear Colleague 1 letter calling
More informationInfectious Diseases and Sexual Health in Southwark
Chapter 7 Infectious Diseases and Sexual Health in Southwark Introduction 7.1 The JSNA 2008 did not reflect the problems of infectious diseases and this chapter redresses this gap. Infectious diseases
More informationTHIRD JOINT CONFERENCE OF BHIVA AND BASHH Dr Zheng Yin. Public Health England. 1-4 April 2014, Arena and Convention Centre Liverpool
THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014 Dr Zheng Yin Public Health England 1-4 April 2014, Arena and Convention Centre Liverpool Patients referral pathway in the first year of HIV care Zheng Yin,
More informationThis resource was first published in 2014 and revised in 2017.
This resource was first published in 2014 and revised in 2017. 0 There is good evidence to suggest that patients eventually diagnosed with HIV infection have had contact with medical services, with symptoms
More informationhttp://www.savinglivesuk.com/ HIV Awareness Study Morning 24 th November 2017 Agenda HIV Basics & Stages of HIV HIV Testing, Health Advising & Sexual Health Saving Lives Antiretroviral Medication Antenatal/Postnatal
More informationINTEGRATING HIV INTO PRIMARY CARE
INTEGRATING HIV INTO PRIMARY CARE ADELERO ADEBAJO, MD, MPH, AAHIVS, FACP NO DISCLOSURE 1.2 million people in the United States are living with HIV infection and 1 in 5 are unaware of their infection.
More informationmedical monitoring: clinical monitoring and laboratory tests
medical monitoring: clinical monitoring and laboratory tests Purpose of monitoring Check on the physical, psychological and emotional condition of the patient Detect other treatable conditions Identify
More informationHPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 2011
HPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 2011 Health Protection Surveillance Centre, www.hpsc.ie Version 2.1 October, 2012 Table of Contents Acknowledgements... 3 Key Points... 3 Introduction...
More informationHIV Testing in Acute Care
HIV Testing in Acute Care Dr. Réka Gustafson Medical Health Officer Director of Communicable Disease Control Vancouver Coastal Health Afshan Nathoo Clinical Coordinator, HIV testing program in acute care
More informationEarly Diagnosis: Serious but non-specific symptom pathway
Early Diagnosis: Serious but non-specific symptom pathway Lily Megaw Becky Gokce Karen Fitzgerald Geraint Jones Luigi de Michele Arun Takhar Introduction Lily Megaw This is a five year programme Based
More informationHIV in primary care. How effective and safe are HIV testing and care in General Practice?
HIV in primary care How effective and safe are HIV testing and care in General Practice? Dr Werner Leber GP and Clinical Lecturer in Primary Care and Public Health Queen Mary, University of London werner.leber@nhs.net
More informationHIV in the United Kingdom: 2009 Report
HIV in the United Kingdom: 2009 Report Key findings The number of people living with HIV in the UK continues to rise, with an estimated 83,000 infected at the end of 2008, of whom over a quarter (27%)
More informationDr Keerti Gedela. Chelsea and Westminster Hospital NHS Foundation Trust, London. 19 th Annual Conference of the British HIV Association (BHIVA)
19 th Annual Conference of the British HIV Association (BHIVA) Dr Keerti Gedela Chelsea and Westminster Hospital NHS Foundation Trust, London 16-19 April 2013, Manchester Central Convention Complex Value
More informationTrends in molecular diagnostics
Trends in molecular diagnostics Detection of target genes of interest Quantification Infectious diseases HIV Hepatitis C & B TB / MAC Cytomegalovirus Herpes simplex Varicella zoster CT/GC HPV Profiling
More informationMoving Forward Sexually Transmitted Infections, including HIV, in Scotland 2005
Moving Forward Sexually Transmitted Infections, including HIV, in Scotland 25 NHS National Services Scotland /Crown Copyright 26 First published November 26 ISBN 1-873772-19-X Brief extracts from this
More informationThe Adult Sickle Cell and Thalassaemia Service Overview. Roald Dahl Transition, Sr CNS and Team Lead for Adult Haemoglobinopathies.
The Adult Sickle Cell and Thalassaemia Service Overview Giselle Padmore-Payne Roald Dahl Transition, Sr CNS and Team Lead for Adult Haemoglobinopathies Background Sickle Cell Disease is an inherited condition
More informationSingle unit transfusion audit PE Smith B Ferguson
Single unit transfusion audit PE Smith B Ferguson Brief introduction Method: A retrospective audit performed in November 2015 Standards: All stable, normovolaemic adult inpatients who require transfusion
More informationImmunodeficiencies HIV/AIDS
Immunodeficiencies HIV/AIDS Immunodeficiencies Due to impaired function of one or more components of the immune or inflammatory responses. Problem may be with: B cells T cells phagocytes or complement
More informationOccupational Exposure to Blood Borne Viruses
Occupational Exposure to Blood Borne Viruses Marissa Herron Occupational Health Support Nurse [BBV] 2014 Aim To raise awareness of the key information and procedures in NHS Lanarkshire's Control of Infection
More informationPILOT STUDY PROPOSAL FOR EARLY DISCHARGE OF LOW-RISK NEUTROPENIC PATIENTS
PILOT STUDY PROPOSAL FOR EARLY DISCHARGE OF LOW-RISK NEUTROPENIC PATIENTS RATIONALE: It is increasingly being recognised that not all neutropenic patients have the same risk of complications during episodes
More informationAn Acute Neurology Service How Can it Help Your MAU?
An Acute Neurology Service How Can it Help Your MAU? Thomas Peukert 13/11/2017 Plan Pilot project data How has the Acute Neurology Service influenced ED admission rates? ED Attendances Aug 2013 Symphony
More informationMANAGEMENT OF SEXUAL EXPOSURE TO HIV: PEPSE
Sandyford Protocols MANAGEMENT OF SEXUAL EXPOSURE TO HIV: PEPSE www.hiv-druginteractions.org If you require information on occupational exposure to blood borne viruses, including HIV, please refer to the
More informationGenital Herpes in the STD Clinic
Genital Herpes in the STD Clinic Christine Johnston, MD, MPH Last Updated: 5/23/2016 uwptc@uw.edu uwptc.org 206-685-9850 Importance of HSV HSV is the leading cause of GUD - HSV is very common HSV-2: 16%
More informationAlister Jones Patient Blood Management Practitioner NHS Blood and Transplant
Alister Jones Patient Blood Management Practitioner NHS Blood and Transplant All medical RCC transfusions (but only 1 in 3 haematology or oncology cases) in 3 x one week periods Medical specialties include:
More informationGenital Tract Infections in HIV- Infected Pregnant Women in South West London
Genital Tract Infections in HIV- Infected Pregnant Women in South West London A Hegazi, N Ramskill, M Norbrook, E Dwyer, S Milne, B Nathan, S Esterich, A ElGalib, T Morgan, A Barbour, P Hay St George s
More informationAcute Oncology: Service Provision in Smaller Cancer Centres Ernie Marshall Clatterbridge Centre for Oncology
Acute Oncology: Service Provision in Smaller Cancer Centres Ernie Marshall Clatterbridge Centre for Oncology Whiston Hospital St Helen s Hospital 350,000 population ~1000 beds Regional Plastics Unit DGH
More informationCase-finding for Hepatitis C in Primary Care
Case-finding for Hepatitis C in Primary Care Dr Shivani Datta, Academic FY2 Supervisors: Professor Matthew Hickman, Dr Jeremy Horwood & Professor Debbie Sharp School of Social and Community Medicine, University
More informationWestern Health Specialist Clinics Access & Referral Guidelines
Haematology Specialist Clinics at Western Health: Western Health runs MBS funded Specialist Clinics on a Wednesday and Thursday afternoon at its Sunshine Hospital site for patients who require assessment
More informationHIV and Public Health: the Basics
HIV and Public Health: the Basics Joy Zeh, RN, MS, Family Nurse Practitioner VCU HIV/AIDS Center HIV and Public Health: the Basics Epidemiology Related Infections and Co-Morbidities Spectrum of HIV Infection
More information25th Annual Conference of the British HIV Association Bournemouth 2019
25th Annual Conference of the British HIV Association Bournemouth 2019 Declarations Dr Ming Lee has no conflicts of interests relevant to this presentation. Dr Ming Lee Dr David Chadwick In 2016 around
More informationNEW PATIENT REGISTRATION
NEW PATIENT REGISTRATION Hospital No. Date of Visit : / / Surname : First Name : Date of birth : / / Country of Birth : Sex : Male Female Transman Transwoman Other (please specify): Is this patient from
More informationHIV monitoring and assessment in older adults
HIV monitoring and assessment in older adults BHIVA National Clinical Audit 2018 Dr Nadia Ekong on behalf of the BHIVA Audit and Standards Sub-Committee Background In 2016, 37.8% of people seen for HIV
More informationHIV in the United Kingdom
HIV in the United Kingdom Valerie Delpech and Alison Brown on behalf of the HIV and AIDS Reporting Section National Infection Service Public Health England Released 15 December 2017 Undetectable=Untransmittable
More informationHIV transmission in the UK within Black African communities: how common is it and how do we prevent it? Dr Valerie Delpech
HIV transmission in the UK within Black African communities: how common is it and how do we prevent it? Dr Valerie Delpech We gratefully acknowledge persons living with HIV, clinicians, health advisors,
More informationHIV in Ireland 2016 Report
HIV in Ireland 2016 Report Acknowledgements In order to accurately track the HIV epidemic in Ireland and to assess the impact of HIV prevention programmes, it is essential to have good quality surveillance
More informationSTATISTICAL PRESS NOTICE NHS REFERRAL TO TREATMENT (RTT) WAITING TIMES DATA JANUARY 2013
STATISTICAL PRESS NOTICE NHS REFERRAL TO TREATMENT (RTT) WAITING TIMES DATA JANUARY 2013 Data are published on consultant-led Referral to Treatment (RTT) waiting times for patients who were treated during
More informationOne week of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection
One week of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection A Elgalib, A Skingsley, O Dosekun, S Alexander, CYW Tong, JA White. Ali Elgalib Consultant in GUM/HIV
More informationManagement of Severe Primary HIV Infection
Management of Severe Primary HIV Infection Martin Fisher Brighton and Sussex University Hospitals Outline What is severe PHI? How frequent is severe PHI? Is this occurring more frequently? Is severe PHI
More information10/17/2015. Chapter 55. Care of the Patient with HIV/AIDS. History of HIV. HIV Modes of Transmission
Chapter 55 Care of the Patient with HIV/AIDS All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. History of HIV Remains somewhat obscure The earlier
More informationOverseas Vistiors upfront charging tariff 2017/18. James Paget University Hospitals NHS Foundation Trust
Overseas Vistiors upfront charging tariff 2017/18 James Paget University Hospitals NHS Foundation Trust From 6 April 2015 relevant NHS bodies should only be using the risk-share agreement with commissioners
More informationWhen PrEP fails. Laura Waters MD FRCP Mortimer Market Centre London
When PrEP fails Laura Waters MD FRCP Mortimer Market Centre London www.aidsunited.org PrEP works If people at risk take it If it s taken in the right way If it s available Commissioned/licensed Affordable
More informationSTIs: Practical Aspects of Management
STIs: Practical Aspects of Management Dr Heather Young FAChSHM DipPH Christchurch Sexual Health heathery@xtra.co.nz 027 343 4963 Sexually Transmitted Infections BACTERIAL STIs: CHLAMYDIA GONORRHOEA SYPHILIS
More informationAnnual Epidemiological Report
November 2018 Annual Epidemiological Report 1 HIV in Ireland, 2017 Key Facts There were 492 diagnoses of HIV notified in 2017, a rate of 10.3 per 100,000 population. The HIV rate in Ireland has been relatively
More informationDr Selena Singh. Guy s and St Thomas NHS Foundation Trust, London THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014
THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014 Dr Selena Singh Guy s and St Thomas NHS Foundation Trust, London 1-4 April 2014, Arena and Convention Centre Liverpool Performance of ceftriaxone 500mgcontaining
More informationUrgent and Emergency Care Lung Cancer Initiative
Urgent and Emergency Care Lung Cancer Initiative Dr Gavin Anderson Consultant Physician Hull & East Yorkshire Hospitals NHS Trust Unscheduled Care in Hull & East Riding Background Local evaluation Sociodemographics
More informationImmunization Update 2018
Immunization Update 2018 Keri Hurley-Kim, PharmD, MPH Assistant Professor, Department of Pharmacy Practice West Coast University School of Pharmacy Conflicts of Interest Keri Hurley-Kim declares no conflicts
More informationAntibiotic Guidelines for URINARY TRACT/ UROLOGY infections
Antibiotic Guidelines f URINARY TRACT/ UROLOGY infections CLINICAL CONDITION USEFUL INFORMATION RECOMMENDATIONS ALTERNATIVE (suitable in serious penicillin allergy) Asymptomatic Bacteriuria (in the absence
More informationINITIATING ART IN CHILDREN: Follow the six steps
INITIATING ART IN CHILDREN: Follow the six steps STEP 1: DECIDE IF THE CHILD HAS CONFIRMED HIV INFECTION Child < 18 months: HIV infection is confirmed if the PCR is positive and the VL is more than 10,000
More informationNORTHERN HEALTH AND SOCIAL CARE TRUST. Waiting Times Summary Report
NORTHERN HEALTH AND SOCIAL CARE TRUST Waiting Times Summary Report April 2014 1 Waiting Times The Northern Health & Social Care Trust monitors waiting time performance against a number of Departmental
More informationSurvey of networks and arrangements for HIV clinical care
1 of 6 20/08/2007 16:40 Survey of networks and arrangements for HIV clinical care Please ensure that you have read the [add link] invitation letter [/add link] before completing this survey. When you have
More informationThe Prevention of Infection with Blood Borne Viruses [BBV]
The Prevention of Infection with Blood Borne Viruses [BBV] Control of Infection Manual Section G Study Morning 25 th November 2014 Marissa Herron Occupational Health Support Nurse [BBV] Aim To raise awareness
More informationCROI 2017 Review: Hepatitis C Coinfection
Mountain West AIDS Education and Training Center CROI 2017 Review: Hepatitis C Coinfection Brian R. Wood, MD Assistant Professor of Medicine Medical Director, Mountain West AETC ECHO Telehealth February
More informationUK clinicians approach to ART in primary HIV infection; comparison with the BHIVA guidelines
UK clinicians approach to ART in primary HIV infection; comparison with the BHIVA guidelines Dr. Julie Fox Victoria Parsons 1, Sarah Fidler 2, Naomi Fitzgerald 3, Simon Collins 4, Andrew Phillips 1, Richard
More informationVisiting Professional Programme: Sexual Health and HIV
Visiting Professional Programme: Sexual Health and HIV 1 Introduction The Guy s and St Thomas NHS Foundation Trust Sexual Health Department is one the largest and most comprehensive sexual health services
More informationGenital herpes is caused by infection with the herpes simplex viruses (HSV) of which there are two types (HSV-1 and HSV-2).
ANO-GENITAL HERPES What s new in this guideline: Patient counselling: key points to cover HSV in immunosuppressed and HIV positive individuals Suppressive therapy does not require consultant review prior
More informationMANITOBA HIV REPORT 2015
MANITOBA HIV REPORT 2015 The Manitoba HIV Program provides information, specialized care, treatment, and support to approximately 1,250 people living with HIV across the province. The Program has two Winnipeg-based
More informationThe Great Imitator Revealed: Syphilis
The Great Imitator Revealed: Syphilis Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles David Geffen School of Medicine Los Angeles, California Learning
More informationCryptococcal Meningitis
Cryptococcal Meningitis Dr N Thumbiran Infectious Diseases Department UKZN Index patient 27 year old female Presented to King Edward Hospital on 17/07/2005 with: Severe headaches Vomiting Photophobia X
More informationGenital herpes is caused by infection with the herpes simplex viruses (HSV) of which there are two types (HSV-1 and HSV-2).
ANO-GENITAL HERPES Introduction Genital herpes is caused by infection with the herpes simplex viruses (HSV) of which there are two types (HSV-1 and HSV-2). Definitions Initial episode: First episode with
More informationHaematology dilemma s to refer or not to refer?
Haematology dilemma s to refer or not to refer? NWL Pathology GP Study Day Dr Fatts Chowdhury Consultant Haematologist in Transfusion Medicine NHS Blood and Transplant Senior Honorary Clinical Lecturer
More informationFaster Cancer Treatment Indicators: Use cases
Faster Cancer Treatment Indicators: Use cases 2014 Date: October 2014 Version: Owner: Status: v01 Ministry of Health Cancer Services Final Citation: Ministry of Health. 2014. Faster Cancer Treatment Indicators:
More informationBreast Pathway Group Everolimus in Advanced Breast Cancer
Breast Pathway Group Everolimus in Advanced Breast Cancer Indication: Hormone receptor positive, HER2 negative advanced breast cancer National Cancer Drug Fund criteria: ER+ve, HER2 ve metastatic breast
More informationAnswers to those burning questions -
Answers to those burning questions - Ann Avery MD Infectious Diseases Physician-MetroHealth Medical Center Assistant Professor- Case Western Reserve University SOM Medical Director -Cleveland Department
More informationTrends in HIV Incidence and Prevalence in the United States
Trends in HIV Incidence and Prevalence in the United States Irene Hall, PhD, FACE 7th International Workshop on HIV Transmission Washington, DC, July 20, 2012 National Center for HIV/AIDS, Viral Hepatitis,
More informationSkin Pathway Group Alemtuzumab in Cutaneous Lymphoma
Skin Pathway Group Alemtuzumab in Cutaneous Lymphoma Indication: Treatment of patients with Cutaneous Lymphoma (Unlicensed use) Disease control prior to Reduced Intensity Conditioning Stem Cell Transplant
More informationLisa K. Fitzpatrick, MD, MPH Associate Professor of Medicine Howard University School of Medicine
Lisa K. Fitzpatrick, MD, MPH Associate Professor of Medicine Howard University School of Medicine HIV Testing Missed Opportunities Acute Retroviral Syndrome Opportunistic Infections Treatment Reminders
More informationDr Melanie Rosenvinge
18 th Annual Conference of the British HIV Association (BHIVA) Dr Melanie Rosenvinge St George s Hospital NHS Trust, London 1820 April 2012, The International Convention Centre, Birmingham A multicentre
More informationCancer of Unknown Primary (CUP) Protocol
1 Department of Oncology. Cancer of Unknown Primary (CUP) Protocol Version: Document type: Document sponsor Designation Document author [ s] Designation[s] Approving committee / Group Ratified by: Date
More informationManaging and streaming of all admissions The Heartlands experience
Managing and streaming of all admissions The Heartlands experience Dr Marwa Mattar, ST6 Acute Medicine Dr Ariyur Balaji, Clinical Lead Acute Medicine BHH Why is this important? Unprecedented demand for
More informationProfessor Norbert Bräu
Sixth Annual BHIVA Conference for the Management of HIV/Hepatitis Co-Infection in collaboration with BASL and BVHG Professor Norbert Bräu James J Peters VA Medical Center, New York, USA COMPETING INTEREST
More informationFertility Desires/Management of Serodiscordant HIV + Couples
Fertility Desires/Management of Serodiscordant HIV + Couples William R. Short, MD, MPH Assistant Professor of Medicine Division Of Infectious Diseases Jefferson Medical College of Thomas Jefferson University
More informationSCOTTISH CANCER REFERRAL GUIDELINES REVIEW 2018
SCOTTISH CANCER REFERRAL GUIDELINES REVIEW 2018 Dr Peter Hutchison, Chair of Review Group WHAT & WHY? Scottish Cancer Referral Guidelines 2014 Scottish Primary Care Cancer Group identified need for some
More informationLessons learnt from other screening programmes : the case of HIV screening
Lessons learnt from other screening programmes : the case of HIV screening Caroline Semaille, Stéphane Le Vu, Françoise Cazein, Christine Larsen, Josiane Pillonel, Florence Lot HIV/AIDS-STI-Hepatitis C
More informationSexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2011
Sexually Transmitted Infection surveillance in Northern Ireland 2012 An analysis of data for the calendar year 2011 Contents Page Summary points. 3 Surveillance arrangements and sources of data.. 4 1:
More informationSexually Transmitted Infections CMT Genital Discharge Dr.U.Y.Joshi. Consultant in Genitourinary Medicine and HIV Hull and East Yorkshire
Sexually Transmitted Infections CMT Genital Discharge 2017 Dr.U.Y.Joshi. Consultant in Genitourinary Medicine and HIV Hull and East Yorkshire Sex superbug -Head line news 2015 Important Sexually Transmitted
More informationTrust Board Meeting in Public: Wednesday 11 July 2018 TB
Trust Board Meeting in Public: Wednesday 11 July 2018 Title Integrated Performance Report: Month 2 Status History For information. The report provides a summary of the Trust s performance against a range
More informationManagement of Immune Reconstitution Inflammatory Syndrome (IRIS)
Management of Immune Reconstitution Inflammatory Syndrome (IRIS) Adult Clinical Guideline from the New York State Department of Health AIDS Institute www.hivguidelines.org Purpose of the IRIS Guideline
More informationTrends in STDs: US Perspective. Michael Towns, M.D. WW Vice President, Medical Affairs BD Diagnostic Systems
Trends in STDs: US Perspective Michael Towns, M.D. WW Vice President, Medical Affairs BD Diagnostic Systems Outline Overview of STD Epidemiology and Current Situation in US Overview of Chlamydia infections
More informationNew Cases Repeat cases Total (New & Repeat) Casualty Inpatients
Sheet1 1 Outpatient Attendance Total Avg. per Day New Cases 9392 361.2 Repeat cases 6261 240.8 Total (New & Repeat) 15653 602.04 Casualty 1076 35.9 Inpatients Total Admissions 1086 36.2 2 Total Discharge
More informationNew guidelines for HIV testing and areas where wider HIV testing policies should be considered.
New guidelines for HIV testing and areas where wider HIV testing policies should be considered. New guidelines 1 from the British HIV Association (BHIVA), the British Association for Sexual Health and
More informationSeveral of the most common STDs are often asymptomatic. Asymptomatic
What Are STDs? Several of the most common STDs are often asymptomatic. Asymptomatic Individuals show no symptoms, or the symptoms are mild and disappear after the onset of the infection Common STDs There
More informationRTT Exception Report
Appendix 3 RTT Exception Report 1. Purpose To provide a summary of factors impacting on 18 week RTT performance and a revised forecast of red rated performance for Quarter 2 2015/16 for the admitted pathway.
More informationFIT for symptomatic patients. Facilitator name
FIT for symptomatic patients Facilitator name Context colorectal cancer Colorectal cancer in the UK 41,804 new cases in 2015 15,903 deaths in 2014 Fourth most common cancer Second most common cause of
More informationECDC update to the EU Commission Think Tank on HIV/AIDS
ECDC update to the EU Commission Think Tank on HIV/AIDS Andrew Amato Head of HIV, STI and V. Hepatitis programme, ECDC Luxembourg, 10-11 December 2013 Outline Main ECDC reports published since last Think
More informationNewly diagnosed HIV patient. Dr. Heila Redpath 06 FEBRUARY 2014
Newly diagnosed HIV patient Dr. Heila Redpath 06 FEBRUARY 2014 PRIMARY HIV INFECTION: SEROCONVERSION SYMPTOMATIC HIV INFECTION AND AIDS ASYMPTOMATIC LATENT INFECTION CLOSED CIRCLES: CD4 cells OPEN
More informationThere are a number of national guidelines and performance standards which support the implementation of a straight to CT pathway.
December 2015 CONTENTS Contents... 2 1 Introduction... 3 2 Case for Change... 3 3 Evidence... 3 3.1 National and regional policy... 3 3.2 Local audit... 4 4 Supporting Work Initiatives... 5 4.1 Identification
More informationClinical and Laboratory Profile of Newly Diagnosed HIV- Infected Patients Attending ART Centre, Government
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-853, p-issn: 2279-861.Volume 15, Issue 8 Ver. VIII (August. 216), PP 19-31 www.iosrjournals.org Clinical and Laboratory Profile of Newly
More informationThe sickle cell outpatient service Information for adult patients with sickle cell disease
The sickle cell outpatient service Information for adult patients with sickle cell disease This information sheet has been given to you to help answer some of the questions you may have about the outpatient
More informationSERVICE TRANSITION PLAN SUMMARY. 1 Jan 2015 IHSS Service Transition Plans (version 8) 1
SERVICE TRANSITION PLAN SUMMARY 1 IHSS Service Transition Plans (version 8) 1 Summary Service Transition Plan Headlines XXX Target milestone date unknown pendency link Activity period Oct Nov c Jan Feb
More informationProfessor Adrian Mindel
Causes of genital ulceration viruses and others Professor Adrian Mindel University of Sydney VIM 16 th August 2012 Outline Definition Causes Epidemiology Diagnosis Definition of genital ulcer A defect
More informationHEFT Pathology Guideline. GP Investigation and Referral Pathways for leucocyte, platelet disturbances and polycythaemia
HEFT Pathology Guideline GP Investigation and Referral Pathways for leucocyte, platelet disturbances and polycythaemia Produced by: Dr Charalampos Kartsios (Consultant Haematologist) and Muhammad Javed
More informationHuman Immunodeficiency Virus. Acquired Immune Deficiency Syndrome AIDS
Human Immunodeficiency Virus Acquired Immune Deficiency Syndrome AIDS Sudden outbreak in USA of opportunistic infections and cancers in young men in 1981 Pneumocystis carinii pneumonia (PCP), Kaposi s
More informationHIV long term complications
HIV- 2015 long term complications 4th Asian Conference on Hepatitis & AIDS 22-23 May 2015, Xi'an, China Kees Brinkman Amsterdam The Netherlands NL 2012: known 17.000 (0,1%) treatment 85% (all) China 2011:
More information2017 Repeat Audit of Red cell and Platelet Transfusion in Adult Haematology Patients
07 Repeat Audit of Red cell and Platelet Transfusion in Adult Haematology Patients Haematology Audit July 07 The audit was conducted on adults undergoing surgery and who received a transfusion during a
More informationNotes Offering Testing for Hepatitis B and C in Primary Care
Testing for these viruses needs to be part of routine clinical practice if we are to reduce the number of people with undiagnosed infection. The request should be normalised. Be aware that the people who
More informationHIV surveillance in Northern Ireland 2016
HIV surveillance in Northern Ireland 2016 Contents Page 1 Surveillance arrangements 3 2 Introduction and key points 4 3 Trend information 5 - New diagnoses Age and gender Route of transmission CD4 surveillance
More informationMycophenolate Mofetil (MMF)
SCG: For Transplant patients The following guidelines are designed to provide information relating to mycophenolate mofetil and to outline the responsibilities of the primary and secondary care teams in
More informationIf your IBD has not been well controlled, or is flaring up quite often, tacrolimus may be added to your treatment.
If your IBD has not been well controlled, or is flaring up quite often, tacrolimus may be added to your treatment. What is tacrolimus? Patient Information Drugs for Inflammatory Bowel Disease Tacrolimus
More informationEvelina London Children s Hospital (ELCH)
Evelina London Children s Hospital (ELCH) Lead Consultant Jenny Handforth PID Pharmacist Faye Chappell Paediatric OPAT CNS Vacant Overview Paediatric OPAT in London Paediatric OPAT ELCH Children s Hospital
More informationSexual Health, HIV, and STDs
Sexual Health, HIV, and STDs Richard J. Wolitski, PhD Deputy Director, Behavioral and Social Science Division of HIV/AIDS Prevention Centers for Disease Control & Prevention Fenway Institute, Boston, MA
More information