scholarly journals Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg?

2018 ◽  
Vol 146 (8) ◽  
pp. 1026-1035 ◽  
Author(s):  
S. Parry ◽  
N. Bundle ◽  
S. Ullah ◽  
G. R. Foster ◽  
K. Ahmad ◽  
...  
Keyword(s):  
Advanced Disease ◽  
Linkage To Care ◽  
Clinic Visit ◽  
Engagement In Care ◽  
Hepatocellular Carcinomas ◽  
Opt Out ◽  
High Prevalence ◽  
Unknown Status ◽  
Routine Hiv Testing ◽  
Virus Testing

AbstractUK 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.

Greater Acceptance of Routine HIV Testing (Opt-Out) by Patients Attending an Infectious Disease Unit in Spain

2012 ◽  
Vol 11 (6) ◽  
pp. 341-344 ◽  
Author(s):  
Francisco Jover-Diaz ◽  
Jose-Maria Cuadrado ◽  
Mariano Matarranz ◽  
Elena Calabuig
Keyword(s):  
Hiv Testing ◽  
Test Performance ◽  
Linkage To Care ◽  
Great Majority ◽  
Routine Procedure ◽  
Opt Out ◽  
Routine Hiv Testing ◽  
Effectiveness Studies ◽  
Disease Unit ◽  
Serology Testing

Objective: Our objective was to determine attitudes and opinions of patients seen in our ID Unit on conducting HIV testing universally. Methods: The survey was conducted in patients between 18 and 65 years without known HIV infection. Requested information about the test was previous embodiment, reasons for rejection, opinion on the universal realization, benefits and/or drawbacks, possible test performance, and availability of results “test negative stigma.” Results: We surveyed 91 patients (54.9% males). Surprisingly, up to 18.7% of patients mistakenly believed that HIV testing is routinely performed without consent. A great majority (98.9%) felt that universal performance on the test would benefit mainly in early diagnosing and/or preventing transmission. Patients younger than 42 years were significantly more prone to doing the test as a routine procedure. Only 4 (4.4%) patients did not participate because they believed they were “not infected.” A vast majority (80.5%) of respondents would prefer to have results within the first 24 hours. In addition, 20.7% would have a problem with confidentiality if HIV serology testing was done. Conclusions: In summary, the vast majority (95.6%) of the surveyed patients had a fair opinion about universal HIV testing. Only 4 patients (4.4%) would not consent to HIV testing (because of low-risk perception). Availability of rapid HIV tests can facilitate fast result delivery, facilitating linkage to care. Considering favorable patients' opinion, recent opt-out screening recommendations, highest HIV prevalence in admitted patients, and cost-effectiveness, studies favor universal HIV testing.

scholarly journals 962. Linkage to Care Outcomes among Known HIV-Positive Patients at a High Prevalence Urban Hospital Emergency Department

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Alexander W Sudyn ◽  
Jeffrey M Paer ◽  
Swetha Kodali ◽  
Samuel Maldonado ◽  
Amesika Nyaku ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Hiv Transmission ◽  
Univariate Analysis ◽  
Linkage To Care ◽  
Retrospective Chart Review ◽  
Retention In Care ◽  
Patient Navigator ◽  
Urban Hospital ◽  
Opt Out ◽  
The Impact

Abstract Background Retention in care of persons with HIV (PWH) is essential for achieving viral suppression and decreasing community transmission. CDC estimates that the 23% of known PWH not retained in care account for 43% of all new transmissions. This study seeks to describe the impact of an opt-out ED screening with navigator-assisted linkage to care (LTC) protocol for out of care PWH. Methods An IRB-approved retrospective chart review was conducted among PWH (prior positive) inadvertently retested in the ED between 2015 and 2018. Univariate and multivariate logistic regression was used to identify factors associated with LTC with patient navigator (PN) support. Factors with p ≤ 0.1 were included in the multivariate analysis as were age and sex at birth. Patients who died were excluded from statistical analyses. Results Among 464 patients who tested positive, 338 (73%) were known positive with 120 (35%) of those out of care at the time of screening. Mean age for this group was 47 (SD 11.9); 57% male, 81% non-Hispanic black, 10% Hispanic, and 6% non-Hispanic white. Fifty-five (46%) patients were successfully LTC, 54 (45%) referred to the state for linkage, and 11 (9%) died. A total of 109 patients were included in the analysis. Univariate analysis was performed for age (F(1, 107) = 0.98, p = 0.324) and female sex at birth (OR = 1.42 [95% CI 0.66, 3.05], p = 0.373) as well as Hispanic race (OR = 3.33 [95% CI 0.84, 13.04], p = 0.085), heterosexual HIV risk (OR = 2.76 [95% CI 1.27, 5.99], p = 0.011), IDU (OR = 0.49 [95% CI 0.21, 1.11], p = 0.088), and other SUD (OR = 0.42 [95% CI 0.19, 0.94], p = 0.035). Only heterosexual HIV risk (OR = 3.01 [95% CI 1.23, 7.32], p = 0.015) maintained significance in the final multivariate model. Conclusion Opt-out ED screening revealed &gt;30% of known positive PWH were out of care at the time of testing; of whom nearly 50% were LTC with PN support. It is possible that persons reporting heterosexual HIV risk may feel less stigmatized and therefore are more likely to LTC. Similarly, the association with SUD, albeit non-significant, may reflect underrepresentation of individuals with SUD in remission among patient navigators. Future opt-out ED screening protocols should build upon diverse care teams to further engage patients with SUD and those at risk for non-heterosexual HIV transmission. Disclosures All Authors: No reported disclosures

Opt-out testing for HIV: perspectives from a high prevalence community in south-east England, UK

2013 ◽  
Vol 24 (4) ◽  
pp. 307-312 ◽  
Author(s):  
A Pollard ◽  
C Llewellyn ◽  
H Smith ◽  
D Richardson ◽  
M Fisher
Keyword(s):  
Opt Out ◽  
High Prevalence ◽  
South East England

Opt-out screening for HIV, hepatitis B and hepatitis C: observational study of screening acceptance, yield and treatment outcomes

2019 ◽  
Vol 37 (2) ◽  
pp. 102-105 ◽  
Author(s):  
Conor Grant ◽  
Sarah O'Connell ◽  
Darren Lillis ◽  
Anne Moriarty ◽  
Ian Fitzgerald ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Screening Programme ◽  
Linkage To Care ◽  
Opt Out ◽  
B Virus ◽  
Lost To Follow Up ◽  
The Impact ◽  
Test Result

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.

scholarly journals Hepatitis C Virus Testing and Linkage to Care in North Carolina and South Carolina Jails, 2012–2014

2016 ◽  
Vol 131 (2_suppl) ◽  
pp. 98-104 ◽  
Author(s):  
Ben T. Schoenbachler ◽  
Bryce D. Smith ◽  
Arlene C. Seña ◽  
Alison Hilton ◽  
Sallie Bachman ◽  
...  
Keyword(s):  
North Carolina ◽  
South Carolina ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Linkage To Care ◽  
Virus Testing

scholarly journals P23 Fragile success: findings from a realist process evaluation of opt-out blood borne virus testing

2019 ◽  
Author(s):  
Seth Francis-Graham ◽  
Cecilia Vindrola ◽  
William Rosenberg ◽  
Tim Rhodes
Keyword(s):  
Process Evaluation ◽  
Opt Out ◽  
Virus Testing

scholarly journals Expanded Hepatitis C Virus (HCV) Testing and Linkage to Care: Program Implementation to Overcome Barriers to Engagement in Care

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Rebecca Eavou ◽  
Ellen Almirol ◽  
Randee Estes ◽  
Michelle Taylor ◽  
Mai Pho ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Program Implementation ◽  
Linkage To Care ◽  
Care Program ◽  
Engagement In Care ◽  
Hcv Testing

scholarly journals High Prevalence of Bone Marrow Involvement and Advanced Disease in Saudi Patients Diagnosed With Hodgkin Lymphoma

Cureus ◽  
2021 ◽  
Author(s):  
Musa F Alzahrani ◽  
Mohammed B Alkahil ◽  
Abdulaziz A Alhusainy ◽  
Abdulmohsen K Alangari ◽  
Mohammed N Almania ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hodgkin Lymphoma ◽  
Advanced Disease ◽  
Bone Marrow Involvement ◽  
High Prevalence ◽  
Saudi Patients

A rapid echocardiographic screening protocol for rheumatic heart disease in Samoa: a high prevalence of advanced disease

2017 ◽  
Vol 27 (8) ◽  
pp. 1599-1605 ◽  
Author(s):  
Marvin Allen ◽  
John Allen ◽  
Take Naseri ◽  
Rebecca Gardner ◽  
Dennis Tolley ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Advanced Disease ◽  
Valve Disease ◽  
Severe Aortic Regurgitation ◽  
Time Period ◽  
High Prevalence ◽  
The World ◽  
Screening Protocol ◽  
Rheumatic Heart

AbstractBackgroundEchocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease.MethodsWe performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students. Children with predefined criteria suspicious for rheumatic hear diseases were referred for a more comprehensive echocardiogram. Complete echocardiograms were classified according to the World Heart Federation guidelines and severity of valve disease.ResultsEchocardiographic screening was performed on 11,434 children, with a mean age of 10.2 years; 51% of them were females. A total of 558 (4.8%) children underwent comprehensive echocardiography, including 49 students who were randomly selected as controls. Definite rheumatic heart disease was observed in 115 students (10.0 per 1000): 92 students were classified as borderline (8.0 per 1000) and 23 with CHD. Advanced disease was identified in 50 students (4.4 per 1000): 15 with severe mitral regurgitation, five with severe aortic regurgitation, 11 with mitral stenoses, and 19 with mitral and aortic valve disease.ConclusionsWe successfully applied a rapid echocardiographic screening protocol to a large number of students over a short time period – 28 days of screening over a 3-year time period – to identify a high prevalence of rheumatic heart disease. We also reported a significantly higher rate of advanced disease compared with previously published echocardiographic screening programmes.

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