An anonymous unlinked sero-prevalence survey of HIVHCV in an urban Emergency Department

Abstract

Background: In 2002, the sero-prevalence of human immunodeficiency virus-1 (HIV) in the Emergency Department (ED), University Hospital, Newark, New Jersey was 10.4%. Both HIV and hepatitis C virus (HCV) are transmitted by injection drug use (IDU) or sexual contact. However, the degree of concurrent positive HCV antibody status in HIV-infected ED patients is unknown.

Objectives: In this study we determined the sero-prevalence of HIV and HIVHCV in HIV-positive patients in the ED.

Study design: A cross-sectional study using an anonymous sero-prevalence survey was conducted from 7/1/2008 to 8/23/2008. Medical records were reviewed and de-identified; remnant blood specimens were also de-identified and tested for HIV antibody, and if positive, HCV antibody.

Results: Of 3488 specimens, 225 (6.5%, 95% CI: 5.7-7.3%) were positive for HIV antibody. Seventy-four patients 74/225 (32.9%, 95% CI: 33.8-46.5%) were unaware of their sero-positivity. Forty percent of HIV positive patients (90/225, 95% CI: 33.8-46.5%) were HCV antibody positive. The highest seroprevalence of HIVHCV antibody was among older patients (≥ 45 years), and patients with positive urine toxicology and elevated liver function tests.

Discussion: Given the high prevalence of HIV and HIVHCV antibody in the ED, routine testing is important for patients ≥ 45 years with positive urine toxicology and elevated liver function tests.

Keywords: AIDS; ALT; AST; AUS; Anonymous unlinked sero-survey; CI; Confidence Interval; ED; ELISA; Emergency Department; Emergency department; Enzyme-Linked Immuno-Sorbent Assay; HCV; HIV; HIVHCV; IDU; LFT; NIDU; NJ; New Jersey; Prevalence HIVHCV antibody; acquired immunodeficiency syndrome; alanine aminotransferase; anonymous unlinked sero-survey; aspartate aminotransferase; hepatitis C virus; human immunodeficiency virus-1; human immunodeficiency virus–hepatitis C virus; injection drug use; liver function tests; non-IDU.