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. 2023 Jan;24(1):6-26.
doi: 10.1111/hiv.13328. Epub 2022 Jun 14.

Blood-borne virus testing in emergency departments - a systematic review of seroprevalence, feasibility, acceptability and linkage to care

Ruth Simmons  1   2 , James Plunkett  1 , Lukasz Cieply  1 , Samreen Ijaz  2   3 , Monica Desai  1   2 , Sema Mandal  1   2
Affiliations
Free article

Blood-borne virus testing in emergency departments - a systematic review of seroprevalence, feasibility, acceptability and linkage to care

Ruth Simmons et al. HIV Med. 2023 Jan.
Free article

Abstract

Background: Blood-borne viruses (BBVs) cause significant morbidity and mortality worldwide. Emergency departments (EDs) offer a point of contact for groups at increased risk of BBVs who may be less likely to engage with primary care. We reviewed the literature to evaluate whether BBV testing in this setting might be a viable option to increase case finding and linkage to care.

Methods: We searched PubMed database for English language articles published until June 2019 on BBV testing in EDs. Studies reporting seroprevalence surveys, feasibility, linkage to care, enablers and barriers to testing were included. Additional searches for grey literature were performed.

Results: Eight-nine articles met inclusion criteria, of which 14 reported BBV seroprevalence surveys in EDs, 54 investigated feasibility and acceptability, and 36 investigated linkage to care. Most studies were HIV-focused and conducted in the USA. Seroprevalence rates were in the range 1.5-17% for HCV, 0.7-1.6% for HBV, and 0.8-13% for HIV. For studies that used an opt-in study design, testing uptake ranged from 2% to 98% and for opt-out it ranged from 16% to 91%. There was a wide range of yield: 13-100% of patients received their test result, 21-100% were linked to care, and 50-91% were retained in care. Compared with individuals diagnosed with HIV, linkage to and retention in care were lower for those diagnosed with hepatitis C. Predictors of linkage to care was associated with certain patient characteristics.

Conclusions: Universal opt-out BBV testing in EDs may be feasible and acceptable, but linkage to care needs to be improved by optimizing implementation. Further economic evaluations of hepatitis testing in EDs are needed.

Keywords: HIV; emergency department; feasibility; hepatitis B; hepatitis C; universal testing.

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References

REFERENCES

    1. Thomas DL. Global elimination of chronic hepatitis. N Engl J Med. 2019;380(21):2041-2050.
    1. D'Amore J, Hung O, Chiang W, Goldfrank L. The epidemiology of the homeless population and its impact on an urban emergency department. Acad Emerg Med. 2001;8(11):1051-1055.
    1. Zucker DM, Choi J, Gallagher ER. Mobile outreach strategies for screening hepatitis and HIV in high-risk populations. Public Health Nurs. 2012;29(1):27-35.
    1. Harris M, Ward E, Gore C. Finding the undiagnosed: a qualitative exploration of hepatitis C diagnosis delay in the United Kingdom. J Viral Hepat. 2016;23(6):479-486.
    1. Levy I, Maor Y, Mahroum N, et al. Missed opportunities for earlier diagnosis of HIV in patients who presented with advanced HIV disease: a retrospective cohort study. BMJ Open. 2016;6(11):e012721.

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