Opt-out panel testing for hiv, hepatitis b and hepatitis c in an urban emergency department: a pilot study

Autor: Suzanne Norris, Patrick K. Plunkett, Aoife G. Cotter, Siobhan O’Dea, I. Fitzgerald, Colm Bergin, Linda Dalby, Catherine Fleming, Sarah O'Connell, Helen Barry, Brendan M. Crowley, Helen Tuite, Darragh Shields, Darren Lillis
Rok vydání: 2016
Předmět:
Male
RNA viruses
Critical Care and Emergency Medicine
HIV Antigens
Physiology
Gastroenterology and hepatology
Prevalence
lcsh:Medicine
HIV Infections
Pilot Projects
Hepacivirus
Pathology and Laboratory Medicine
medicine.disease_cause
Hepatitis
burden
Hospitals
Urban
0302 clinical medicine
Immunodeficiency Viruses
Medicine and Health Sciences
Mass Screening
030212 general & internal medicine
lcsh:Science
education.field_of_study
Multidisciplinary
Hepatitis C virus
HIV diagnosis and management
Hematology
Hepatitis C
Middle Aged
Hepatitis B
Body Fluids
Infectious hepatitis
Blood
Medical Microbiology
Viral Pathogens
Viruses
Infectious diseases
Female
030211 gastroenterology & hepatology
Pathogens
Anatomy
Emergency Service
Hospital
Research Article
Adult
medicine.medical_specialty
Population
Viral diseases
virus
Microbiology
Young Adult
03 medical and health sciences
Virology
Internal medicine
Retroviruses
medicine
Humans
Viremia
education
Microbial Pathogens
Liver diseases
Mass screening
Hepatitis B Surface Antigens
Flaviviruses
business.industry
Lentivirus
lcsh:R
Organisms
Biology and Life Sciences
HIV
Hepatitis C Antibodies
medicine.disease
Diagnostic medicine
Hepatitis viruses
Cross-Sectional Studies
Immunology
lcsh:Q
business
Ireland
Viral Transmission and Infection
Blood sampling
Zdroj: PLoS ONE, Vol 11, Iss 3, p e0150546 (2016)
PLoS ONE
Popis: Objectives Studies suggest 2 per 1000 people in Dublin are living with HIV, the level above which universal screening is advised. We aimed to assess the feasibility and acceptability of a universal opt-out HIV, Hepatitis B and Hepatitis C testing programme for Emergency Department patients and to describe the incidence and prevalence of blood-borne viruses in this population. Methods An opt-out ED blood borne virus screening programme was piloted from March 2014 to January 2015. Patients undergoing blood sampling during routine clinical care were offered HIV 1&2 antibody/antigen assay, HBV surface antigen and HCV antibody tests. Linkage to care where necessary was co-ordinated by the study team. New diagnosis and prevalence rates were defined as the new cases per 1000 tested and number of positive tests per 1000 tested respectively. Results Over 45 weeks of testing, of 10,000 patient visits, 8,839 individual patient samples were available for analysis following removal of duplicates. A sustained target uptake of >50% was obtained after week 3.97(1.09%), 44(0.49%) and 447(5.05%) HIV, Hepatitis B and Hepatitis C tests were positive respectively. Of these, 7(0.08%), 20(0.22%) and 58(0.66%) were new diagnoses of HIV, Hepatitis B and Hepatitis C respectively. The new diagnosis rate for HIV, Hepatitis B and Hepatitis C was 0.8, 2.26 and 6.5 per 1000 and study prevalence for HIV, Hepatitis B and Hepatitis C was 11.0, 5.0 and 50.5 per 1000 respectively. Conclusions Opt-out blood borne viral screening was feasible and acceptable in an inner-city ED. Blood borne viral infections were prevalent in this population and newly diagnosed cases were diagnosed and linked to care. These results suggest widespread blood borne viral testing in differing clinical locations with differing population demographic risks may be warranted.
Databáze: OpenAIRE
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