Reassessing HIV Detection Strategies: An Analysis of Opportunistic Screening vs. Indicator-Condition-Driven Diagnosis in Valencia, Spain.

Our study assessed the characteristics of people living with HIV (PLWH) detected via opportunistic screening in Valencia (Spain) to determine diagnoses potentially missed under a more restrictive, indicator-condition diagnostic strategy. We conducted a retrospective analysis of electronic health records of 97 PLWH diagnosed between April 2019 and August 2022. The main outcomes reported were patient CD4+ T cell count, known HIV risk factors at diagnosis, and missed opportunities for diagnosis, defined as the failure of a previously untested patient to undergo HIV testing despite attending previous visits to healthcare facilities prior to diagnosis. Successful linkage to care was achieved for 95.9% of diagnosed patients. Half of the PLWH were diagnosed late, while 47.8% did not meet the criteria for indicator-condition-driven HIV diagnosis at the time of their diagnosis. Additionally, 52.2% did not receive HIV testing despite an average of 5.1 ± 6.0 healthcare visits in the 12 months prior to diagnosis. Spaniards had more missed opportunities for diagnosis than foreigners (64% vs. 40%, p = 0.02). Depending solely on an indicator-condition-driven HIV diagnosis approach could result in 47.8% of cases being missed. Including "migrants" as a testing criterion could lower missed diagnoses to 25.3% but might create inequities in prevention access. In conclusion, our findings provide valuable insights to enhance HIV testing, early diagnosis, and linkage to care. While it is crucial to uphold the indicator-condition-driven HIV diagnosis as baseline practice, improving screening strategies will decrease late diagnoses and missed opportunities, thereby effectively contributing to end the epidemic.

Evaluación del panel gastrointestinal xTAG(R)-GPP de Luminex en el diagnóstico de las gastroenteritis agudas / Evaluation of the Luminex xTAG(R)-GPP (Gastrointestinal Pathogen Panel) in the diagnosis of diseases with acute diarrhoea

Introducción: La mayoría de laboratorios de microbiología utilizan diferentes técnicas para el diagnóstico de las infecciones gastrointestinales. Algunas requieren hasta 72 h para obtener resultados definitivos. Material y métodos: El panel gastrointestinal de Luminex (xTAG-GPP, Luminex Molecular Diagnostics, Toronto, Canadá) se trata de un ensayo cualitativo multiplex rápido y sensible capaz de detectar e identificar simultáneamente los 15 patógenos más frecuentes causantes de gastroenteritis. Nuestro objetivo ha sido evaluar este panel multiplex comparándolo con los métodos habituales empleados en nuestro laboratorio. Resultados: Se analizaron 225 muestras de heces. A través de los métodos convencionales fueron 74 las muestras positivas (32,9%). A través de Luminex fueron 137 las muestras positivas (60,9%). Conclusión: El uso del panel gastrointestinal de Luminex puede mejorar el diagnóstico de las infecciones gastrointestinales principalmente porque proporciona resultados en menos de 8 h. Determinados microorganismos deben interpretarse con precaución y basándose en datos clínicos y epidemiológicos del paciente (AU)

Introduction: Most Microbiology laboratories use different techniques for the diagnosis of gastrointestinal infections. Some of which require at least 72 hours to obtain final results. Material and Methods: The gastrointestinal panel Luminex (xTAG-GPP, Luminex Molecular Diagnostics, Toronto, Canada) is a qualitative multiplex fast and sensitive assay able to detect and to identify the 15 most common pathogens causing gastrointestinal infection simultaneously. We evaluated this multiplex panel comparing it with conventional methods used in our laboratory. Results: We analyzed 225 samples of feces. Through the conventional methods were positive 74 samples (32.9%). Through the Luminex method were positive 137 samples (60.9%). Conclusions: The use of the xTAG(R) GPP system in Clinical Microbiology can improve the diagnosis of gastrointestinal infectious because it provides results in less than 8 hours. Some pathogens should be applied with caution and should be interpreted based on the patients clinical data (AU)