Opt-out screening for HIV, hepatitis B and hepatitis C: observational study of screening acceptance, yield and treatment outcomes
| Autor: | Conor Grant, Geraldine McMahon, Suzanne Norris, Patrick K. Plunkett, Una Kennedy, Darragh Shields, Linda Dalby, Brendan M. Crowley, Gerard Hughes, Darren Lillis, Anne Moriarty, I. Fitzgerald, Sarah O'Connell, Ciaran Bannan, Susan McKiernan, Colm Bergin, Helen Tuite |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Hepatitis C virus Human immunodeficiency virus (HIV) HIV Infections Critical Care and Intensive Care Medicine medicine.disease_cause Choice Behavior 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Mass Screening 030212 general & internal medicine Hepatitis B virus business.industry General Medicine Hepatitis C Emergency department Hepatitis B Phlebotomy Middle Aged medicine.disease Diagnostic Services Emergency Medicine 030211 gastroenterology & hepatology Observational study Female business Emergency Service Hospital Ireland |
| Zdroj: | Emergency medicine journal : EMJ. 37(2) |
| ISSN: | 1472-0213 |
| Popis: | BackgroundWe initiated an emergency department (ED) opt-out screening programme for HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) at our hospital in Dublin, Ireland. The objective of this study was to determine screening acceptance, yield and the impact on follow-up care.MethodsFrom July 2015 through June 2018, ED patients who underwent phlebotomy and could consent to testing were tested for HIV, HBV and HCV using an opt-out approach. We examined acceptance of screening, linkage to care, treatment and viral suppression using screening programme data and electronic health records. The duration of follow-up ranged from 1 to 36 months.ResultsOver the 36-month study period, there were 140 550 ED patient visits, of whom 88 854 (63.2%, 95% CI 63.0% to 63.5%) underwent phlebotomy and 54 817 (61.7%, 95% CI 61.4% to 62.0%) accepted screening for HIV, HBV and HCV, representing 41 535 individual patients. 2202 of these patients had a positive test result. Of these, 267 (12.1%, 95% CI 10.8% to 13.6%) were newly diagnosed with an infection and 1762 (80.0%, 95% CI 78.3% to 81.7%) had known diagnoses. There were 38 new HIV, 47 new HBV and 182 new HCV diagnoses. 81.5% (95% CI 74.9% to 87.0%) of known patients who were not linked were relinked to care after screening. Of the new diagnoses, 86.2% (95% CI 80.4 to 90.8%) were linked to care.ConclusionAlthough high proportions of patients had known diagnoses, our programme was able to identify many new infected patients and link them to care, as well as relink patients with known diagnoses who had been lost to follow-up. |
| Databáze: | OpenAIRE |
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