Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg?
UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) ra...
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| Veröffentlicht in: | Epidemiology and infection 2018-06, Vol.146 (8), p.1026-1035 |
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| creator | Parry, S. Bundle, N. Ullah, S. Foster, G. R. Ahmad, K. Tong, C. Y. W. Balasegaram, S. Orkin, C. |
| description | UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. ED testing was valuable as one-third of those requiring LTC (new, disengaged or unknown status patients) had advanced disease. |
| doi_str_mv | 10.1017/S0950268818000870 |
| format | Article |
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R. ; Ahmad, K. ; Tong, C. Y. W. ; Balasegaram, S. ; Orkin, C.</creator><creatorcontrib>Parry, S. ; Bundle, N. ; Ullah, S. ; Foster, G. R. ; Ahmad, K. ; Tong, C. Y. W. ; Balasegaram, S. ; Orkin, C.</creatorcontrib><description>UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. ED testing was valuable as one-third of those requiring LTC (new, disengaged or unknown status patients) had advanced disease.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S0950268818000870</identifier><identifier>PMID: 29661260</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Acquired immune deficiency syndrome ; Adults ; AIDS ; Alcohol ; Antigens ; Blood ; Blood tests ; CD4 antigen ; Departments ; Emergency medical care ; Emergency medical services ; Epidemiology ; Health surveillance ; Hepatitis ; Hepatocellular carcinoma ; HIV ; HIV and HEPATITIS ; Human immunodeficiency virus ; Infections ; Liver ; Liver cancer ; Medical tests ; Original Paper ; Partnership agreements ; Patients ; Public health ; Serology ; Substance abuse treatment ; Underserved populations ; Viral infections ; Viruses</subject><ispartof>Epidemiology and infection, 2018-06, Vol.146 (8), p.1026-1035</ispartof><rights>Copyright © Cambridge University Press 2018</rights><rights>Cambridge University Press 2018 2018 Cambridge University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-f91493149251fafa2fb9076e77913143790025075baadb231ca5494dfdd142613</citedby><cites>FETCH-LOGICAL-c471t-f91493149251fafa2fb9076e77913143790025075baadb231ca5494dfdd142613</cites><orcidid>0000-0001-6482-3207</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184937/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184937/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29661260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parry, S.</creatorcontrib><creatorcontrib>Bundle, N.</creatorcontrib><creatorcontrib>Ullah, S.</creatorcontrib><creatorcontrib>Foster, G. R.</creatorcontrib><creatorcontrib>Ahmad, K.</creatorcontrib><creatorcontrib>Tong, C. Y. W.</creatorcontrib><creatorcontrib>Balasegaram, S.</creatorcontrib><creatorcontrib>Orkin, C.</creatorcontrib><title>Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg?</title><title>Epidemiology and infection</title><addtitle>Epidemiol. Infect</addtitle><description>UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. 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R.</au><au>Ahmad, K.</au><au>Tong, C. Y. W.</au><au>Balasegaram, S.</au><au>Orkin, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg?</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol. Infect</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>146</volume><issue>8</issue><spage>1026</spage><epage>1035</epage><pages>1026-1035</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><abstract>UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. 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| source | Jstor Complete Legacy; PubMed Central |
| subjects | Acquired immune deficiency syndrome Adults AIDS Alcohol Antigens Blood Blood tests CD4 antigen Departments Emergency medical care Emergency medical services Epidemiology Health surveillance Hepatitis Hepatocellular carcinoma HIV HIV and HEPATITIS Human immunodeficiency virus Infections Liver Liver cancer Medical tests Original Paper Partnership agreements Patients Public health Serology Substance abuse treatment Underserved populations Viral infections Viruses |
| title | Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg? |
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