Physicians Struggle to Clinically Diagnose Early HIV-Infection
Journal of the American Medical Association study reveals early detection is easily missed

published on July 15, 2014

Vancouver, BC [July 15, 2014] — In the run up to the 20th International AIDS Conference, North America’s HIV/AIDS research experts say, despite the belief that early HIV infection presents with a well recognized flu-like syndrome, most physicians are unable to use clinical skills to differentiate those who should and should not be tested for HIV infection.

In a study published in the July 15 issue of the Journal of the American Medical Association (JAMA), researchers at the BC Centre for Excellence in HIV/AIDS and University of British Columbia, Oregon Health and Science University, and Duke University Medical Centre analyzed data from over 24,000 patients, and discovered physicians have great difficulty recognizing the presence or absence of early HIV infection through clinical exam alone.

During the period of early HIV infection, past research shows 50-90 percent of patients develop one or more of the following symptoms: fever, nausea/vomiting, weight loss, rash, oral ulcers, and swollen lymph glands. While identifying HIV infection early can greatly contribute to reduced mortality and the likelihood of further HIV transmission, these symptoms are too non-specific for physicians to recognize, whereas the absence of symptoms does not reliably exclude infection.

“This study is not meant to be critical of physicians because of the limitations of our ability to discern who should and should not be tested for HIV infection,” says Dr. Evan Wood, lead author and Canada Research Chair in Inner City Medicine at the University of British Columbia Faculty of Medicine. “Rather, this study highlights the importance of routine HIV testing, just like we routinely test for other health conditions. We are extremely fortunate in British Columbia that many hospitals are offering HIV testing as part of standard hospital admitting, and we have new provincial guidelines for the routine offer of HIV tests in adults on an ongoing basis.”

In May, B.C. became the first province in Canada to introduce guidelines for routine HIV testing for all adult British Columbians. “We realized through our four-year STOP HIV/AIDS pilot program that many clinical opportunities to make a diagnosis and offer treatment were being missed. Based on this experience we developed and released guidelines for front line practitioners recommending routine HIV screening for adults. This combination of increased testing and access to free antiretroviral drugs is both evidence based and effective,” says Dr. Perry Kendall, provincial health officer. “Today’s study in JAMA provides further evidence B.C. is leading the way globally in demonstrating how HIV can be controlled and virtually eliminated.”

Despite recommendations from the World Health Organization and U.S. Centre for Disease Control, most jurisdictions in the US and globally are falling behind the approach taken in B.C. A recent survey of 376 US hospitals found that less than 10 percent of hospitals reported universal screening of inpatients and outpatients and less than 35 percent reported screening some or all adult patients.

“A simple blood test in conjunction with clinical evaluation enables us to detect this disease early and provide life-saving treatment,” says Dr. Julio Montaner, director, British Columbia Centre for Excellence in HIV/AIDS, chair of AIDS Research and head of Division of AIDS at the University of British Columbia Faculty of Medicine. “We know routine HIV testing works, and our goal is to bring the success we have had in British Columbia in controlling HIV and AIDS to the rest of Canada and around the world.”

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About the British Columbia Centre for Excellence in HIV/AIDS 
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians living with HIV.

About the University of British Columbia 
The University of British Columbia (UBC) is one of North America’s largest public research and teaching institutions, and one of only two Canadian institutions consistently ranked among the world’s 40 best universities. Surrounded by the beauty of the Canadian West, it is a place that inspires bold, new ways of thinking that have helped make it a national leader in areas as diverse as community service learning, sustainability and research commercialization. UBC offers more than 55,000 students a range of innovative programs and attracts $550 million per year in research funding from government, non-profit organizations and industry through 7,000 grants.

Note to editors: Dr. Evan Wood is available for interview by phone.

For more information:

Lisa Carver
604-648-3451
604-340-9351
Lisa.carver@edelman.com

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BC Centre for Excellence in HIV/AIDS

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Physicians Struggle to Clinically Diagnose Early HIV-Infection
Journal of the American Medical Association study reveals early detection is easily missed

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Physicians Struggle to Clinically Diagnose Early HIV-InfectionJournal of the American Medical Association study reveals early detection is easily missed

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Physicians Struggle to Clinically Diagnose Early HIV-Infection
Journal of the American Medical Association study reveals early detection is easily missed