Collaboration experience between Dermatology Unit and Infectious Disease Clinic in Modena: optimization strategies for HIV, hepatitis and syphilis screening tests

Abstract

Introduction Screening tests for HIV, HBV, HCV and syphilis are very important to detect and treat these infections at an early stage and prevent their diffusion inside communities. Sexually Transmitted Diseases Ambulatory of Dermatology Unit (STDs-DU) and “Test & Counselling” Ambulatory of Infectious Disease Clinic (T&C-IDC) in Modena began collaboration in 2010 and adopted a common diagnostic serological profile since 2013. Objective The main aim of the study was to analyse the results of screening tests performed in the STDs-DU and T&C-IDC, comparing the results obtained after the adoption of the shared protocol with the previous period. The secondary objective was to evaluate the efficacy of our collaboration in term of number of new diagnoses and linkage to care. Materials and Methods Consecutive patients referred to the STDs-DU and T&C-IDC from January 2010 to December 2016, with at least one performed screening test for HIV, HBV, HCV and syphilis were enrolled. Referral of patients with a new infection was obtained by capture-recapture methods in hospital databases. Results During the seven-years observation we collected 13117 admittances for 9154 patients. We observed a significant increase in the number of screening tests (p<0.001) and ratio between tests and admissions (p=0.002). 644 (7.0%) people with at least one infection were diagnosed. Among these, the most common was syphilis (41.9%), followed by HBV (25.7%), HCV (21.4%) and HIV (10.9%). Syphilis and HCV occurred predominantly in Italians (72.5% and 81.1%) and males (75.7% and 75.5%), while foreign-born (85.5%) mainly harboured HBV infection. HIV diagnosis was detected more frequently among males (67.1%) with a similar proportion between Italians and foreign-born. 543 out of 644 (84.3%) patients were linked to care. Conclusions The cooperation between STDs-DU and T&C-IDC has proven to work well increasing the diagnosis over the time and obtaining good results in linkage to care