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. 2012;7(10):e46437.
doi: 10.1371/journal.pone.0046437. Epub 2012 Oct 2.

Twelve months of routine HIV screening in 6 emergency departments in the Paris area: results from the ANRS URDEP study

Enrique Casalino  1 , Bruno Bernot, Olivier Bouchaud, Chakib Alloui, Christophe Choquet, Elisabeth Bouvet, Florence Damond, Sandra Firmin, Aurore Delobelle, Beatrice Ename Nkoumazok, Guillaume Der Sahakian, Jean-Paul Viard, Olivier Zak Dit Zbar, Elisabeth Aslangul, Anne Krivine, Julie Zundel, Jade Ghosn, Patrice Nordmann, Yann-Erick Claessens, Tassadit Tahi, Bruno Riou, Agnès Gautheret-Dejean, Christine Katlama, Pierre Hausfater, Françoise Brun-Vézinet, Dominique Costagliola
Affiliations

Twelve months of routine HIV screening in 6 emergency departments in the Paris area: results from the ANRS URDEP study

Enrique Casalino et al. PLoS One. 2012.

Abstract

Objective: In October 2009 the French National Authority for Health recommended that HIV testing be proposed at least once to all persons aged 15 to 70 years in all healthcare settings. We examined whether routine HIV screening with a rapid test in emergency departments (EDs) was feasible without dedicated staff, and whether newly diagnosed persons could be linked to care.

Methods: This one-year study started in December 2009 in 6 EDs in the Paris area, using the INSTI™ test. Eligible individuals were persons 18 to 70 years old who did not present for a vital emergency, for blood or sexual HIV exposure, or for HIV screening. Written informed consent was required.

Results: Among 183 957 eligible persons, 11 401 were offered HIV testing (6.2%), of whom 7936 accepted (69.6%) and 7215 (90.9%) were tested (overall screening rate 3.9%); 1857 non eligible persons were also tested. Fifty-five new diagnoses of HIV infection were confirmed by Western blot (0.61% (95% CI 0.46-0.79). There was one false-positive rapid test result. Among the newly diagnosed persons, 48 (87%) were linked to care, of whom 36 were not lost to follow-up at month 6 (75%); median CD4 cell count was 241/mm(3) (IQR: 52-423/mm(3)).

Conclusions: Screening rates were similar to those reported in opt-in studies with no dedicated staff. The rate of new diagnoses was similar to that observed in free anonymous test centres in the Paris area, and well above the prevalence (0.1%) at which testing has been shown to be cost-effective.

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Conflict of interest statement

Competing Interests: No authors of the ANRS URDEP study have any financial or personal relationships with people or organizations that could inappropriately influence this work, although most members of the group have, at some stage in the past, received funding from a variety of pharmaceutical companies for research, travel grants, speaking engagements or consultancy fees: Elisabeth Aslangul has received travel grants from Sanofi Aventis, Pfizer and Bristol-Myers-Squibb. Elisabeth Bouvet, Dominique Costagliola and Jean-Paul Viard have received travel grants, consultancy fees, honoraria and study grants from various pharmaceutical companies, Abbott, Boehringer-Ingelheim, Bristol-Myers-Squibb, Gilead Sciences, Glaxo-Smith-Kline, Janssen, Merck-Sharp & Dohme-Chibret, Roche and ViiV Healthcare. Françoise Brun-Vézinet has received travel grants, consultancy fees and study grants from Gilead Sciences, Janssen, ViiV healthcare and Merck- Sharp & Dohme-Chibret. Enrique Casalino has received travel grants from various pharmaceutical companies, Abbott, Boehringer-Ingelheim, Bristol-Myers-Squibb, Gilead Sciences, Glaxo-Smith-Kline, Janssen, Merck-Sharp & Dohme-Chibret, Roche and ViiV Healthcare. Florence Damond has received travel grants, and honoraria from Merck-Sharp & Dohme-Chibret. Jade Ghosn has received travel grants, honoraria and study grants from various pharmaceutical companies including Boehringer-Ingelheim, Bristol-Myers-Squibb, Gilead Sciences, Janssen, Merck-Sharp & Dohme-Chibret, Roche and ViiV Healthcare. Pierre Hausfater has received consultancy fees, honoraria and study grants from biodiagnostic companies, ThermoFisher Scientific, BRAHMS biomarkers, BioMerieux, Radiometer, and Philips. Christine Katlama has received travel grants, honoraria and consultantancy fees from Bristol-Myers-Squibb, Gilead Sciences, Janssen, Merck-Sharp & Dohme-Chibret, and ViiV Healthcare. Bruno Riou has received travel grants, consultancy fees, honoraria and study grants from various pharmaceutical and biomarker companies, Sanofi, Glaxo-Smith-Kline, ThermoFisher Brahms, OctoPharma, LFB, Sangart. Olivier Bouchaud has received travel grants, honoraria and study grants from various pharmaceutical companies, Abbott, Boehringer-Ingelheim, Bristol-Myers-Squibb, Gilead Sciences, Glaxo-Smith-Kline, Janssen, Merck-Sharp & Dohme-Chibret, Roche, ViiV Healthcare, Sigma Tau, and Novartis. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Flow-chart of procedures for HIV screening with a rapid test in the ANRS URDEP study.
Figure 2
Figure 2. Factors associated with test proposal to eligible persons.
Figure 3
Figure 3. Factors associated with being newly diagnosed HIV-seropositive among eligible tested persons.
See this image and copyright information in PMC

Comment in

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