Opt-out panel testing for HIV, hepatitis B and hepatitis C in an urban emergency department: A pilot study

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Opt-out panel testing for HIV, hepatitis B and hepatitis C in an urban emergency department: A pilot study

Authors

O'Connell, S.,Lillis, D.,Cotter, A.,O'Dea, S.,Tuite, H.,Fleming, C.,Crowley, B.,Fitzgerald, I.,Dalby, L.,Barry, H.,Shields, D.,Norris, S.,Plunkett, P. K.,Bergin, C.

Citation
2016
PLoS ONE

11

3
Type
Cross-sectional
Virus targets
Hepatitis B
Hepatitis C
Other targets
HIV
Interventions
HBV testing and linkage to care
HCV testing and linkage to Care
Linkage to care
Screening and diagnosis
Testing
Setting
National
Target populations
General Population
Country of development
Ireland
Target location
Ireland
DOI
10.1371/journal.pone.0150546 PMCID: PMC4788349
Testing strategy
Laboratory-based antibody test
Countries of included studies
Ireland

Health outcomes

Number new diagnoses,Linkage to care,Loss to follow-up cascade

Testing strategy

Laboratory-based antibody test

Abstract

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. Method(s): 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. Result(s): 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. Conclusion(s): 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. Copyright © 2016 O'Connell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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22 Jan 2021