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. 2014 Sep;104(9):1695-9.
doi: 10.2105/AJPH.2014.301953. Epub 2014 Jul 17.

Prevalence of undiagnosed acute and chronic HIV in a lower-prevalence urban emergency department

Phillip C Moschella  1 , Kimberly W Hart, Andrew H Ruffner, Christopher J Lindsell, D Beth Wayne, Matthew I Sperling, Alexander T Trott, Carl J Fichtenbaum, Michael S Lyons
Affiliations

Prevalence of undiagnosed acute and chronic HIV in a lower-prevalence urban emergency department

Phillip C Moschella et al. Am J Public Health. 2014 Sep.

Abstract

Objectives: We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from a region of the United States with low-to-moderate HIV prevalence.

Methods: This cross-sectional seroprevalence study consecutively enrolled patients aged 18 to 64 years within randomly selected sampling blocks in a Midwestern urban ED in a region of lower HIV prevalence in 2008 to 2009. Participants were compensated for providing a blood sample and health information. After de-identification, we assayed samples for HIV antibody and nucleic acid.

Results: There were 926 participants who consented and enrolled. Overall, prevalence of undiagnosed HIV was 0.76% (95% confidence interval [CI] = 0.30%, 1.56%). Three participants (0.32%; 95% CI = 0.09%, 0.86%) were nucleic acid-positive but antibody-negative and 4 (0.43%; 95% CI = 0.15%, 1.02%) were antibody-positive.

Conclusions: Even when the absolute prevalence is low, a considerable proportion of undetected HIV cases in an ED population are acute. Identification of acute HIV in ED settings should receive increased priority.

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Figures

FIGURE 1—
FIGURE 1—
Flow diagram of participant samples tested for acute and chronic HIV in a Midwestern urban emergency department: 2008–2009.
See this image and copyright information in PMC

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