Optimization strategies for HIV, hepatitis and syphilis testing in Infectious Disease Clinic and Dermatology Unit of Modena: seven-years results of collaboration experience

Introduction: Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis infections modify the epidemiology and presentation of each other. Screening tests are very important for detection of sexually transmitted infections (STIs), for treating them at an early stage and prevent the diffusion inside communities. “Test & Counselling” Ambulatory of Infectious Disease Clinic (T&C-IDC) and Sexually Transmitted Diseases Ambulatory of Dermatology Unit (STDs-DU) of the Azienda Ospedaliero-Universitaria Policlinico of Modena began collaboration in 2010 and adopted a common diagnostic profile since 2013. The main objective was to analyse the results of screening tests performed in the T&C-IDC and STDs-DU during the study period in order to identify early HIV, HBV, HCV and syphilis infections. The secondary objective was to evaluate the efficacy of our collaboration in term of number of new STIs diagnoses and linkage to care. Material and Methods: Consecutive patients referred to the T&C-IDC and STDs-DU from January 2010 to December 2016, with at least one performed screening test for HIV, HBV, HCV and syphilis were enrolled. Demographic and laboratory data were acquired from each patient. Linkage to care of positive patients was obtained through a join of different outpatient clinical databases. Results: During the seven-years observation we collected 13117 admittances for 9154 patients. Median age was 35.1 years ± 12.6 and foreign-born population represents 29% of the tested people. People who resulted positive for at least one screening test increased during the study period. A total of 668 infections were detected in 644 patients. Discussion: The agreement between T&C-IDC and STDs-DU has proven to work well increasing the diagnosis over the time and obtaining a good results in linkage to care, which allows to patients with positive screening test to be sent to the pertinent Clinic for further investigations and therapeutic management.