New HIV screening opportunities

Issue: BCMJ, vol. 61 , No. 4 , May 2019 , Pages 183 News

A study from the BC Centre for Excellence in HIV/AIDS (BC-CfE) uncovered new opportunities to diagnose individuals living with HIV in the health care system. In 2017, nearly a quarter of those diagnosed with HIV in BC had a CD4 count that was low, a major indicator of a weakened immune system and advanced HIV disease. HIV testing rates have steadily increased in the province since 2014, with more than 87 900 British Columbians accessing an HIV test in the last quarter of 2018. However, data analyzed by the BC-CfE showed 1 in 7 individuals living with HIV in BC could have been diagnosed earlier—if health care providers had recognized certain key clinical conditions as triggers for HIV screening.

According to the BC-CfE study, published in PLOS-One, individuals aged 40 years or older, heterosexuals, people living in remote areas, and people who had ever injected drugs were more likely to have had a missed opportunity for an earlier HIV diagnosis. Researchers defined a missed HIV testing opportunity as an encounter with a health care provider due to a condition or clinical symptoms possibly associated with HIV. This included recurrent pneumonia, shingles among individuals younger than 50 years old, and anemia. A late diagnosis of HIV can affect individuals by increasing their risk of hospitalization, progression to AIDS, and premature mortality. Missed opportunities for earlier HIV diagnoses can also increase the risk of transmission of the virus to others and can put increased demand on the health care system.

BC HIV testing guidelines, available since 2014, recommend health care providers offer individuals an HIV test every 5 years. Individuals considered at high-risk of HIV are recommended to have an HIV test at least once per year.

The study, “Missed opportunities for earlier diagnosis of HIV in British Columbia, Canada: A retrospective cohort study,” is available at

. New HIV screening opportunities. BCMJ, Vol. 61, No. 4, May, 2019, Page(s) 183 - News.

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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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