How medicine is broken, and how we can fix it

Background HIV is an infectious disease transmitted through blood or body fluids. The main cause of death for patients with HIV are opportunistic infections (OIs), since patients have a weakened immune system, leaving them susceptible to any infectious agent. OIs are becoming less frequent because of better immunity of HIV patients and earlier screening for OIs for treatment and prevention. As per international guidelines, it is recommended that patients with HIV are screened for hepatitis B, hepatitis C, and tuberculosis upon HIV diagnosis because of their frequent co-infection with HIV and similar route of transmission. However, gaps in screening for common co-infections still occur. The aim of this study was to estimate the prevalence of hepatitis B, hepatitis C, and tuberculosis among HIV-positive patients, and to assess the adherence of healthcare workers to the screening guidelines of common HIV co-infections. Methods This was a retrospective analysis of all HIV-positive patients diagnosed at KAMC-Riyadh from 2000 to 2018. Data regarding results of infectious diseases were extracted from each patient’s medical file. Results A total of 126 patients tested positive for HIV in KAMC-Riyadh during the study period. 53 of these patients were screened for hepatitis B, of whom four were positive; 55 were screened for hepatitis C, of whom four were also positive, and 72 patients were screened for tuberculosis, of whom seven were positive. The remainder of the patients were never screened for any of the diseases. Conclusion More than 40% of patients with HIV were not screened for either hepatitis B, hepatitis C, or tuberculosis, which are the most common co-infections with HIV. These diseases may progress quickly and could be managed if discovered early or prevented. These results demonstrate the need for a comprehensive HIV program that involves early screening and protection against all infectious diseases.