Recently diagnosed sexually HIV-infected patients: seroconversion interval, partner notification period and a high yield of HIV diagnoses among partners
Am. Worm et al., Recently diagnosed sexually HIV-infected patients: seroconversion interval, partner notification period and a high yield of HIV diagnoses among partners, QJM-MON J A, 94(7), 2001, pp. 379-390
Citations number
29
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
QJM-MONTHLY JOURNAL OF THE ASSOCIATION OF PHYSICIANS
We collected data on the outcome of partner notification (PN) for 356 index
patients (iPs) newly diagnosed with HIV, all sexually infected, in six Eur
opean countries, 1995-96. The PN period (the period during which exposed pa
rtners should be notified about their risk of being HIV infected) could be
defined on the basis of last negative HIV test in 170/356 (48%), from other
key dates for 12, and for 14 more on the sole basis of known HIV exposure
(total 196/356, 55%), However, of the 170 iPs with a last negative HIV test
date, PN period was not defined in 52 (31%), even though 28/52 were recent
seroconverters (negative HIV test within 24 months of HIV diagnosis). Disc
repancies in PN period evaluation were common: of the 85 iPs for whom PN pe
riod was reportedly defined as '3 months before last HIV-negative date', th
e period actually used was equal to this in only 12. A user-friendly worksh
eet would simplify the task of eliciting and using key dates to define the
PN period. Forms on PN outcome were received for 166/200 (83%) reported cur
rent partners, but only 124/508 (24%) ex-partners. Fifty-two of 290 (18%) n
otified partners already knew they were HIV-positive, and 38/130 (29%) noti
fied partners for whom pre-PN status was negative or unknown were HIV-posit
ive on post-PN testing. Results of HIV tests (if any) after PN were unknown
for 37/133 (28%) current partners not already known to be HIV-positive, an
d for 71/105 (68%) ex-partners-a doubling of the information loss rate. Not
ification of 133 current and 105 ex-partners not previously identified as H
IV-positive thus produced 28 (21%) and 10 (10%) new HIV diagnoses, respecti
vely. The total yield of HIV diagnoses was 38/100 (38%) partners of recent
seroconverters (22 already known plus 16 PN-diagnosed), compared with 52/19
0 (27%) partners of other iPs (30 already known plus 22 PN-diagnosed). We p
ropose prioritization for PN of partners of recent seroconverters, augmente
d surveillance for HIV diagnoses and recurrence in PN networks of at-risk,
non-notified partners, and new measures that preserve anonymity to alert po
tential and past sexual contacts of HIV-diagnosed individuals who are unabl
e or unwilling to assist in PN.