Enhanced Collection of Laboratory Data in HIV Surveillance Among 5 States with Confidential Name-based HIV Infection Reporting, 2005-2006



Kristen Mahle Gray*, 1, Tebitha Kajese2, Erin Crandell-Alden3, Bridget J Anderson4, Debbie Wendell5, Allison Crutchfield6, Terry Jackson7, H. Irene Hall1Author Comment: for the Laboratory Reporting Workgroup§

1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
2 Business Computer Applications, 2002 Summit Blvd, Suite 880, Atlanta, GA, USA
3 HIV/STD/VH/TB Epidemiology Section, Division of Communicable Diseases, Bureau of Epidemiology, Michigan Department of Community Health, Lansing, MI, USA
4 Bureau of HIV/AIDS Epidemiology, AIDS Institute, New York State Department of Health, Albany, NY, USA
5 HIV/AIDS Program, Louisiana Office of Public Health, New Orleans, LA, USA
6 Disease Control and Environmental Epidemiology Division, Colorado Department of Public Health and Environment, Denver, CO, USA
7 Division of HIV/STD, Indiana State Department of Health, Indianapolis, IN, USA


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© Mahle Gray et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Mailstop E-47, 1600 Clifton Road, NE, Atlanta, GA 30333, USA; Tel: 404-639-2050; Fax: 404-639-2980; E-mail: blo9@cdc.gov
§ Laboratory Reporting Workgroup Participants: Elizabeth Hamilton3, Maria Kouznetsova4 and Pamela Montoya6.


Abstract

Laboratory data reported through HIV surveillance can provide information about disease severity and linkage to care; however these measures are only as accurate as the quality and completeness of data reported. Using data from five states that implemented enhanced collection of laboratory data in HIV surveillance from 2005-2006, we determined completeness of reporting, stage of disease at diagnosis, the most common opportunistic illnesses (OI) at diagnosis, and linkage to medical care. Methods to enhance laboratory reporting included increasing active surveillance efforts, identifying laboratories not reporting to HIV surveillance, increasing electronic reporting, and using laboratory results from auxiliary databases. Of 3,065 persons ≥13 years of age diagnosed with HIV, 35.5% were diagnosed with stage 3 (AIDS) and 37.7% progressed to stage 3 within 12-months after diagnosis. Overall, 78.5% were linked to care within 3 months; however, a higher proportion of persons with ≥1 CD4 or viral load test was found among whites compared with blacks/African Americans (82.1% vs 73.6%, p<0.001). Few (12.3%) had an OI within 3 months of diagnosis. The completeness of laboratory data collected through surveillance was improved with enhanced reporting and provided a more accurate picture of stage of disease and gaps in linkage to care. Additional interventions are needed to meet the goals of the National HIV/AIDS Strategy on linkage to care and the reduction of HIV-related disparities.

Keywords: HIV diagnoses, HIV surveillance, CD4 and VL reporting, linkage to care..