Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments
Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments
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DOI：
10.1038/s41598-019-51128-6
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发表时间：
2019-10-09
影响因子：
4.6
通讯作者：
Little, Susan J.
中科院分区：
文献类型：
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作者：
Hoenigl, Martin;Mathur, Kushagra;Little, Susan J.
在急诊科(ED)进行普遍的艾滋病毒和丙型肝炎筛查可以覆盖到那些不太可能进行其他检测的人群。这项分析的目的是评估圣地亚哥两家急诊室的普遍选择退出艾滋病毒和丙型肝炎筛查。对13岁至岁的人(不包括已知为艾滋病毒阳性或最近12个月内报告艾滋病毒检测的人)进行艾滋病毒筛查，使用第四代艾滋病毒抗原/抗体分析；对1945年至1965年期间出生的人进行丙型肝炎筛查。在16个月的时间里，对12575人进行了艾滋病毒检测，导致33例(0.26%)新的艾滋病毒诊断，其中30例(90%)成功地与护理有关。全民筛查还确定了74名未接受护理的12个月HIV+患者，其中50人(68%)成功地与护理联系在一起。在一个月的时间里，对905人进行了丙型肝炎病毒抗体检测，血清阳性率为9.9%(90/905)，61名新发现或从未接受治疗的丙型肝炎患者进行了丙型肝炎病毒RNA检测，其中31人(51%)呈阳性(占全部参与者的3.4%，其中18名新发现的RNA阳性者占所有参与者的2%)，13/31人(42%)与CARE有关。新诊断的丙型肝炎病毒感染率是新诊断的艾滋病毒感染率的7倍，突显了在急诊室进行丙型肝炎病毒筛查的重要性。
Universal HIV and HCV screening in emergency departments (ED) can reach populations who are less likely to get tested otherwise. The objective of this analysis was to evaluate universal opt-out HIV and HCV screening in two EDs in San Diego. HIV screening for persons aged 13-64 years (excluding persons known to be HIV+ or reporting HIV testing within last 12 months) was implemented using a 4th generation HIV antigen/antibody assay; HCV screening was offered to persons born between 1945 and 1965. Over a period of 16 months, 12,575 individuals were tested for HIV, resulting in 33 (0.26%) new HIV diagnoses, of whom 30 (90%) were successfully linked to care. Universal screening also identified 74 out-of-care for >12-months HIV+ individuals of whom 50 (68%) were successfully relinked to care. Over a one-month period, HCV antibody tests were conducted in 905 individuals with a seropositivity rate of 9.9% (90/905); 61 seropositives who were newly identified or never treated for HCV had HCV RNA testing, of which 31(51%) resulted positive (3.4% of all participants, including 18 newly identified RNA positives representing 2% of all participants), and 13/31 individuals (42%) were linked to care. The rate of newly diagnosed HCV infections exceeded the rate of newly diagnosed HIV infections by >7-fold, underlining the importance of HCV screening in EDs.