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. 2022 Aug;23(3):305-310.
doi: 10.1177/17511437211007775. Epub 2021 Apr 26.

The value of routine blood-borne virus testing in the intensive care unit

Yu Yang Tan  1 , Malcolm G Booth  2
Affiliations

The value of routine blood-borne virus testing in the intensive care unit

Yu Yang Tan et al. J Intensive Care Soc. 2022 Aug.

Abstract

Background: ICU patients may require renal replacement therapy (RRT). Sharing RRT equipment carries a risk of BBV transmission, which mainly relates to Hepatitis B (HBV), Hepatitis C (HCV) and HIV. Since 2012, all Glasgow Royal Infirmary ICU patients undergo routine BBV screening, with RRT machines allocated for patients with specific BBV statuses. Routine BBV testing is beneficial to both the individual and society. This study aims to determine if routine BBV testing in the ICU contributes to the discovery of undiagnosed BBV infections.

Methods: This single-centre retrospective observational study examined prospectively collected clinical data from 1069 ICU admissions. Proportions were compared using a two-proportion z-test and a logistic regression model was carried out to determine if deprivation quintile was independently associated with the seroprevalence of BBVs.

Results: The BBV seroprevalence in the cohort studied: 0.45% (HBV), 11.7% (HCV), and 0.91% (HIV). The seroprevalence of HBV in the cohort studied was similar to that of Scotland (p = 0.11), but the seroprevalence of HCV (p < 0.001) and HIV (p = 0.01) were significantly higher than that of Scotland. The relationship between deprivation and BBV seroprevalence was explored for HCV only. The only independent variable associated with a reactive anti-HCV test result was "current or previous illicit drug use" (adjusted odds ratio of 40.2; 95% confidence interval of 21.1-76.4; p < 0.001).

Conclusion: This study shows that routine BBV testing in the ICU is useful in discovering new BBV infections. This is the first observational study focusing on the value of routine BBV testing in an ICU setting to our knowledge.

Keywords: Blood-borne pathogens; intensive care unit; seroprevalence; testing.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study consort diagram. Flow diagram showing selection of eligible admissions included in the study. anti-HCV: hepatitis C antibody; BBV: blood-borne virus; GRI: Glasgow Royal Infirmary; HBsAg: hepatitis B surface antigen; HIV-Ab/Ag: HIV-antibody/antigen; ICU: intensive care unit.
See this image and copyright information in PMC

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