Five-year risk of HIV diagnosis subsequent to 147 hospital-based indicator diseases: a Danish nationwide population-based cohort study
Received 25 November 2015
Accepted for publication 31 March 2016
Published 6 September 2016 Volume 2016:8 Pages 333—340
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Professor Pasquale Ferrante
Peer reviewer comments 2
Editor who approved publication: Professor Vera Ehrenstein
Lars Haukali Omland,1 Rebecca Legarth,1 Magnus Glindvad Ahlström,1 Henrik Toft Sørensen,2 Niels Obel1
1Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Background: It has been suggested that targeted human immunodeficiency virus (HIV) testing programs are cost-effective in populations with an HIV prevalence >0.1%. Several indicator diseases are known to be associated with increased risk of HIV infection, but estimates of HIV frequency in persons with relevant indicator diseases are nonexistent.
Methods: In a nationwide population-based cohort study encompassing all Danish residents aged 20–60 years during 1994–2013, we estimated the 5-year risk of an HIV diagnosis (FYRHD) after a first-time diagnosis of 147 prespecified potential indicator diseases. To estimate the risk of HIV diagnosis in the general population without any indicator diseases, we calculated the FYRHD starting at age 25, 35, 45, and 55 years.
Results: The risk in the male general population was substantially higher than the female general population, and the risk was lower in the older age categories. Individuals of African origin had a higher FYRHD than individuals of Danish origin. A number of diseases were identified with a FYRHD >0.1%, with infectious diseases, such as syphilis, hepatitis, and endocarditis, associated with a particularly high FYRHD. Other potential indicator diseases, such as most urologic, nephrologic, rheumatologic, and endocrine disorders were generally associated with a low FYRHD.
Conclusion: Our study identified a large number of indicator diseases associated with a FYRHD >0.1%. These data can be used as a tool for planning targeted HIV screening programs.
Keywords: HIV, indicator diseases, HIV screening, public health
Erratum for this paper has been published
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