Seroprevalence and demographic factors associated with hepatitis B, hepatitis C and HIV infection from a hospital emergency department testing programme, London, United Kingdom, 2015 to 2016

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Seroprevalence and demographic factors associated with hepatitis B, hepatitis C and HIV infection from a hospital emergency department testing programme, London, United Kingdom, 2015 to 2016

Authors

Bundle, N.,Balasegaram, S.,Parry, S.,Ullah, S.,Harris, R. J.,Ahmad, K.,Foster, G. R.,Tong, C. Y. W.,Orkin, C.

Citation
2019
Eurosurveillance

24

27 (1800377)
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
Country of development
United Kingdom
Target location
United Kingdom
DOI
10.2807/1560-7917.ES.2019.24.27.1800377
Testing strategy
Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test
Laboratory-based antibody test
Laboratory-based PCR/RNA (confirmatory) test
Countries of included studies
United Kingdom

Health outcomes

Number new diagnoses,Linkage to care

Testing strategy

Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test

Abstract

Background: Progress towards HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) elimination requires local prevalence estimates and linkage to care (LTC) of undiagnosed or disengaged cases. Aim(s): We aimed to estimate seroprevalence, factors associated with positive blood-borne virus (BBV) serology and numbers needed to screen (NNS) to detect a new BBV diagnosis and achieve full LTC from emergency department (ED) BBV testing. Method(s): During a 9-month programme in an ED in east London, England, testing was offered to adult attendees having a full blood count (FBC). We estimated factors associated with positive BBV serology using logistic regression and NNS as the inverse of seroprevalence. Estimates were weighted to the age, sex and ethnicity of the FBC population. Result(s): Of 6,211 FBC patients tested, 217 (3.5%) were positive for at least one BBV. Weighted BBV seroprevalence was 4.2% (95% confidence interval (CI): 3.6-4.9). Adjusted odds ratios (aOR) of positive BBV serology were elevated among patients that were: male (aOR: 2.7; 95% CI: 1.9-3.9), 40-59 years old (aOR: 1.9; 95% CI: 1.4-2.7), of Black British/Black other ethnicity (aOR: 1.8; 95% CI: 1.2-2.8) or had no fixed address (aOR: 2.9; 95% CI: 1.5-5.5). NNS to detect a new BBV diagnosis was 154 (95% CI: 103-233) and 135 (95% CI: 93-200) to achieve LTC. Conclusion(s): The low NNS suggests routine BBV screening in EDs may be worthwhile. Those considering similar programmes should use our findings to inform their assessments of anticipated public health benefits. Copyright © 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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21 Jan 2021