HIV Indicator Diseases in Hospital and Primary Care

NCT05225493 | Unknown

• 1 other identifier: MEC-2021-0277
• Study Type: observational
• Target: 1,500
• Locations: 1 country
• Sites: 1

Brief Summary

Patients are frequently evaluated by physicians for medical work-up of HIV indicator conditions in hospital and in primary care at the general practitioner. Testing for HIV is indicated with HIV indicator disorder but often omitted in clinical work-up. Besides the fact that HIV testing is forgotten, there are other reasons such as an underestimation of the risk of HIV in the event of indicator disorders, stigma and difficulties in discussing the test with a patient. Also and more relevant for primary care than for the hospital, practical challenges can exist for a patient to go to a laboratory, or costs are a hurdle. This project focuses on improving HIV indicator condition driven testing in different settings of the HIV epidemic, initially in the Netherlands as low HIV prevalence setting followed by an assessment of its benefit in different international settings. A specific focus will also be on the Rotterdam area in the Netherlands which has a high prevalence of undiagnosed HIV in the Netherlands. The ultimate aim is to decrease the number of undiagnosed HIV in populations, improve the 90-90-90 HIV cascade of care goals particularly its first pillar, and to help supporting the UNAIDS goal to end HIV/AIDS

Conditions

HIV Infections; Primary Health Care; Acquired Immunodeficiency Syndrome; Sexually Transmitted Diseases, Viral; Herpes Zoster; Dermatitis, Seborrheic; Pneumonia; Infectious Mononucleosis; Psoriasis; Candida Infection; Lymphadenopathy; Uterine Cervical Dysplasia; Weight Loss; Diarrhea Chronic; Leukopenia; Thrombocytopenia; AIDS Defining Illness; HIV Indicator Condition

Keywords

General Practitioner, Medical Specialist, HIV indicator condition, HIV risk group, AIDS

Outcome Measures

Primary Outcomes (2)

• The number of adequately performed HIV tests of identified HIV indicator conditions in relation to the total number of identified HIV indicator conditions by physicians in hospital settings during the project.

  3 year

• The number of adequately performed HIV tests of identified HIV indicator conditions in relation to the total number of identified HIV indicator conditions by general practitioners in primary care during the project.

  3 year

Secondary Outcomes (7)

• The number of positive HIV tests in relation to the total number of HIV tests for identified HIV indicator conditions.

  3 year

• The percentage of adequately HIV tested patients per HIV indicator condition and per medical specialism.

  31 year

• The prevalence of HIV indicator conditions in primary care and hospitals.

  3 year

• The incidence of HIV indicator conditions in primary care and hospitals.

  3 year

• A sensitive and specific supervised artificial Intelligence tool that recognizes risk factors for HIV and HIV indicator conditions through natural language processing (NLP) and supports the hospital and primary care in proactive HIV testing policies.

  3 year

Other Outcomes (2)

• The number of HIV tests in relation to the total number of HIV tests done by gender, ethnical background, age, previous HIV test and HIV indicator conditions of the patient, primary care setting and hospital setting.

  3 year

• Center for Disease Control and Prevention (CDC) HIV classification of the patients with an HIV positive test.

  3 year

Study Arms (2)

Hospital

Medical specialists in hospitals and their patients aged 18 years and older in the participating hospitals who are diagnosed there with an HIV indicator condition.

Behavioral: Peer to peer feedback

Primary care

General practitioners and their patients aged 18 years and older in the participating general practices who are diagnosed there with an HIV indicator condition.

Behavioral: Peer to peer feedback; Diagnostic Test: HIV rapid test

Interventions

Peer to peer feedback BEHAVIORAL

HIV experts contact non-HIV specialised treating physicians on individual patient care to recommend HIV testing

Hospital; Primary care

HIV rapid test DIAGNOSTIC_TEST

Free HIV rapid tests are provided to non-HIV specialised treating physicians to use in individual patient care in patients at risk of HIV

Primary care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Medical specialists, general practitioners and their patients aged 18 years and older in the participating hospitals and primary care who present there with an HIV indicator condition.

You may qualify if:

• Diagnosis of an HIV indicator conditions.

You may not qualify if:

• Below 18 years of age
• Recent HIV test (\< 12 months, except for mononucleosis-like disease and STDs)

Sponsors & Collaborators

• Erasmus Medical Center: lead
• Huisartspraktijk Gezondheidscentrum Mathenesserlaan: collaborator
• TU Delft department of Artificial Intelligence and MyTomorrows: collaborator
• Huisartsen Groep Rotterdam: collaborator
• AwareHIV Project Group: collaborator
• Huisartspraktijk Handellaan: collaborator
• Huisartspraktijk Leerdam: collaborator
• Huisartspraktijk Capelle ad IJssel: collaborator
• Leiden University Medical Center: collaborator
• Maasstadziekenhuis: collaborator
• Rijnstate Hospital: collaborator
• Medical Center Haaglanden: collaborator

Study Sites (1)

Carlijn CCE Jordans

Rotterdam, South Holland, 3015GD, Netherlands

RECRUITING

Related Publications (1)

• Jordans CCE, Niemantsverdriet-Rokx L, Struik JL, van der Waal EC, van der Voorn PVJM, Bakker N, Verbon A, Bindels PJE, Rokx C. Implementing HIV teams to improve HIV indicator condition-guided testing in general practitioner centers in the Netherlands. BMC Prim Care. 2024 Dec 27;25(1):440. doi: 10.1186/s12875-024-02666-0.

  PMID: 39731054 DERIVED

MeSH Terms

Conditions

HIV Infections; Acquired Immunodeficiency Syndrome; Sexually Transmitted Diseases, Viral; Herpes Zoster; Dermatitis, Seborrheic; Pneumonia; Infectious Mononucleosis; Psoriasis; Candidiasis; Lymphadenopathy; Uterine Cervical Dysplasia; Weight Loss; Leukopenia; Thrombocytopenia

Condition Hierarchy (Ancestors)

Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Varicella Zoster Virus Infection; Herpesviridae Infections; DNA Virus Infections; Dermatitis; Skin Diseases; Skin and Connective Tissue Diseases; Sebaceous Gland Diseases; Skin Diseases, Eczematous; Skin Diseases, Papulosquamous; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Epstein-Barr Virus Infections; Leukocyte Disorders; Hematologic Diseases; Hemic and Lymphatic Diseases; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Mycoses; Bacterial Infections and Mycoses; Precancerous Conditions; Neoplasms; Uterine Cervical Diseases; Uterine Diseases; Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Body Weight Changes; Body Weight; Signs and Symptoms; Cytopenia; Blood Platelet Disorders

Central Study Contacts

Casper Rokx, MD PhD

CONTACT

+31681336328; c.rokx@erasmusmc.nl

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD PhD

Study Record Dates

• First Submitted: January 17, 2022
• First Posted: February 4, 2022
• Study Start: January 1, 2020
• Primary Completion: May 1, 2024
• Study Completion: May 1, 2024
• Last Updated: February 4, 2022

Record last verified: 2022-01

Locations

NL (1)