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. 2015 Jul;33(7):917-9.
doi: 10.1016/j.ajem.2015.04.006. Epub 2015 Apr 10.

Opportunities for earlier HIV diagnosis in a pediatric ED

Michelle D Eckerle  1 , Madjimbaye Namde  2 , Carolyn K Holland  3 , Andrew H Ruffner  2 , Kim W Hart  2 , Christopher J Lindsell  2 , Jennifer L Reed  1 , Michael S Lyons  4
Affiliations

Opportunities for earlier HIV diagnosis in a pediatric ED

Michelle D Eckerle et al. Am J Emerg Med. 2015 Jul.

Abstract

Objectives: Emergency department (ED) HIV screening is recommended but challenging to implement and of uncertain effectiveness in pediatric EDs (PEDs). We sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohort of young adults diagnosed with HIV.

Methods: This retrospective cohort study reviewed PED records of a group of young adults receiving HIV care in an urban hospital setting. Pediatric ED visits were selected for review if they took place after the patient's estimated time of HIV acquisition and before their eventual diagnosis. Charts were reviewed to determine whether HIV infection was suspected and whether testing was offered.

Results: Among a cohort of HIV-positive young adults, only 3 (3.6%; 95% confidence interval, 0.9-10.8) of 84 were seen in the PED during the time they were undiagnosed but likely to be infected with HIV. Among these subjects, there was no documentation that HIV testing was offered or refused nor was there documented suspicion of HIV.

Conclusions: There are opportunities for earlier diagnosis of HIV in PEDs, affirming the importance of HIV screening implementation in these settings. However, PEDs are unlikely to have the same frequency of contact with undiagnosed individuals as do adult EDs. Alternative methods of accessing at-risk adolescent populations must be identified.

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Conflict of interest statement

Conflict of interest: The authors have no conflicts of interest to disclose.

References

    1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. The New England journal of medicine. 2011;365(6):493–505. - PMC - PubMed
    1. Thompson MA, Aberg JA, Hoy JF, Telenti A, Benson C, Cahn P, et al. Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society-USA panel. JAMA: the journal of the American Medical Association. 2012;308(4):387–402. - PubMed
    1. Emmanuel PJ, Martinez J. Adolescents and HIV infection: the pediatrician’s role in promoting routine testing. Pediatrics. 2011;128(5):1023–9. - PubMed
    1. Qaseem A, Snow V, Shekelle P, Hopkins R, Jr, Owens DK, Clinical Efficacy Assessment Subcommittee ACoP Screening for HIV in health care settings: a guidance statement from the American College of Physicians and HIV Medicine Association. Annals of internal medicine. 2009;150(2):125–31. - PubMed
    1. Rothman RE, Lyons MS. HIV screening in emergency departments. Introduction. Annals of emergency medicine. 2011;58(1 Suppl 1):S1. - PubMed

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