Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, United States.
University of San Diego School of Medicine, San Diego, California, United States.
Sci Rep. 2019 Oct 9;9(1):14479. doi: 10.1038/s41598-019-51128-6.
Universal HIV and HCV screening in emergency departments (ED) can reach populations who are less likely to get tested otherwise. The objective of this analysis was to evaluate universal opt-out HIV and HCV screening in two EDs in San Diego. HIV screening for persons aged 13-64 years (excluding persons known to be HIV+ or reporting HIV testing within last 12 months) was implemented using a 4 generation HIV antigen/antibody assay; HCV screening was offered to persons born between 1945 and 1965. Over a period of 16 months, 12,575 individuals were tested for HIV, resulting in 33 (0.26%) new HIV diagnoses, of whom 30 (90%) were successfully linked to care. Universal screening also identified 74 out-of-care for >12-months HIV+ individuals of whom 50 (68%) were successfully relinked to care. Over a one-month period, HCV antibody tests were conducted in 905 individuals with a seropositivity rate of 9.9% (90/905); 61 seropositives who were newly identified or never treated for HCV had HCV RNA testing, of which 31 (51%) resulted positive (3.4% of all participants, including 18 newly identified RNA positives representing 2% of all participants), and 13/31 individuals (42%) were linked to care. The rate of newly diagnosed HCV infections exceeded the rate of newly diagnosed HIV infections by >7-fold, underlining the importance of HCV screening in EDs.
在急诊科（ED）进行普遍的 HIV 和 HCV 筛查可以覆盖到那些不太可能接受检测的人群。本分析的目的是评估在圣地亚哥的两家急诊科进行普遍的选择退出 HIV 和 HCV 筛查的效果。对年龄在 13-64 岁之间的人群（不包括已知 HIV+或在过去 12 个月内报告过 HIV 检测的人群）进行了 4 代 HIV 抗原/抗体检测；对 1945 年至 1965 年期间出生的人群进行了 HCV 筛查。在 16 个月的时间里，对 12575 人进行了 HIV 检测，发现了 33 例（0.26%）新的 HIV 诊断病例，其中 30 例（90%）成功地获得了治疗。普遍筛查还发现了 74 例超过 12 个月未接受治疗的 HIV+个体，其中 50 例（68%）成功地重新获得了治疗。在一个月的时间里，对 905 人进行了 HCV 抗体检测，血清阳性率为 9.9%（90/905）；新发现或从未接受 HCV 治疗的 61 例血清阳性者进行了 HCV RNA 检测，其中 31 例（51%）呈阳性（占所有参与者的 3.4%，包括 18 例新发现的 RNA 阳性，占所有参与者的 2%），其中 13/31 例（42%）与治疗机构建立了联系。新诊断的 HCV 感染率是新诊断的 HIV 感染率的 7 倍以上，这突出了 ED 中 HCV 筛查的重要性。
