Article Figures & Data
Tables
Symptom Reported in the Literature NAMCS/NHAMCS Equivalent Reason(s) for Visit Note: Symptoms reported by more than 25% of patients in Schacker et al,2 Hecht et al,4 and Daar et al.5 HIV = human immunodeficiency virus; NAMCS = National Ambulatory Medical Care Survey; NHAMCS = National Hospital Ambulatory Medical Care Survey. 1. Fever Fever, chills, feeling hot 2. Pharyngitis Throat soreness, throat pain, tonsillitis 3. Lymphadenitis Sore glands, swollen or enlarged glands 4. Myalgia Unspecified muscle pain, ache, soreness, discomfort 5. Athralgia Unspecified joint pain, ache, soreness, discomfort 6. Fatigue Tiredness, fatigue 7. Night sweats Excessive sweating 8. Nausea Nausea 9. Vomiting Vomiting 10. Diarrhea Diarrhea 11. Rash Skin rash 12. Weight loss Weight loss 13. Oral ulcer Mouth ulcer 14. Headache Headache, pain in head 15. Neck stiffness Limitation of movement, neck stiffness 16. Loss of appetite Decreased appetite 17. Malaise General ill feeling Symptom Numerator Estimate (95% CI) Denominator Estimate (95% CI) Prevalence Estimate (Range) Note: Prevalence estimates were obtained by dividing the numerator estimate by the denominator estimate. The low range estimate was obtained by dividing the low numerator estimate by the high denominator estimate, and the high range estimate by dividing the high numerator estimate by the low denominator estimate. CI = confidence interval. Fever 14,394 (13,880–15,936) 2,175,551 (1,723,031–2,628,071) 0.66 (0.53–0.92) Rash 7,540 (5,998–9,082) 1,344,060 (966,721–1,721,399) 0.56 (0.35–0.94) Pharyngitis 8,568 (7,026–10,436) 6,415,111 (5,528,853–7,301,369) 0.13 (0.10–0.19)
Additional Files
Supplemental Tables
Supplemental Table 1. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments and Hospital Clinics With Fever and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 2. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments, and Hospital Clinics With Rash and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 3. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments, and Hospital Clinics With Pharyngitis and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 4. Numerator Estimate: Annual Number of Patients Aged 13 to 54 Years With Primary HIV Infection Visiting Physician Offices, Emergency Departments, and Hospital Clinics With Fever, Rash, or Pharyngitis.
Files in this Data Supplement:
- Supplemental data: Tables 1-4 - PDF file; 5 pages, 141 KB
The Article in Brief
Cost-Effectiveness of Expanded Testing for Primary HIV Infection
By Andrew Coco, MD
Background: Primary HIV infection, which has flu-like symptoms, can be difficult to diagnose. This study looked at whether widespread testing for primary HIV infection would be cost-effective.
What this study found: In a group of 2 million hypothetical patients with fever, other viral symptoms and at least one HIV risk factor, expanded testing would identify 17,054 cases and avoid infection in 435 sexual partners. Based on a cost-effectiveness analysis, expanded testing for primary HIV infection has a high probability of being cost-effective.
Implications
� The findings suggests that widespread testing for primary HIV infection in patients with fever or other viral symptoms could be cost-effective.
� The authors believe that large-scale testing would be similar to screening for diseases such as colon cancer and breast cancer in its cost-effectiveness, and could help reduce the rate of HIV in the United States.
