Early Diagnosis of Human Immunodeficiency Virus (HIV) by an Emergency Department-Based HIV Screening Program

2006 ◽  
Vol 13 (5Supplement 1) ◽  
pp. S21-S21
Author(s):  
M. S. Lyons
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Early Diagnosis ◽  
Screening Program ◽  
Hiv Screening ◽  
Immunodeficiency Virus

scholarly journals The Role of Targeted HIV Screening in the Emergency Department: A Scoping Review

2020 ◽  
Vol 18 ◽  
Author(s):  
Ornella Spagnolello ◽  
Bernadette Gallagher ◽  
Nazir Lone ◽  
Giancarlo Ceccarelli ◽  
Gabriella D’Ettorre ◽  
...  
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Scoping Review ◽  
Significant Proportion ◽  
The United States ◽  
Hiv Prevalence ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
The Impact

Background: Human immunodeficiency virus (HIV) infection continues to expand worldwide and a significant proportion of infection is still undiagnosed. Recent studies have addressed the impact and feasibility of ‘opt-out’ HIV screening in Emergency Departments (EDs) in urban settings at high HIV prevalence, whereas little is known about the yield of implementing ‘targeted’ HIV testing especially in low-prevalence areas. Objective: The present study undertakes a scoping review of research carried out on the implementation of targeted HIV screening in adult EDs to determine the impact, feasibility and acceptability of HIV testing in different HIV prevalence settings. Design: Online databases (EMBASE, MEDLINE) were used to identify papers published between 2000 to 2020. A threeconcept search was employed with HIV (HIV, Human immunodeficiency virus infection, HIV infections), targeted testing (Target, screening or testing) and emergency medicine (Emergency Service, emergency ward, A&E, accident and emergency or Emergency Department) (28th February 2020). Only full-text articles written in English, French, Spanish or Italian and using impact and/or feasibility and/or acceptability of the program as primary or secondary outcomes were analysed. Results: The search returned 416 articles. Of these, 12 met inclusion criteria and were included in the final review. Most of the included studies were carried out in the United States (n=8; 67%) and in areas of high HIV prevalence (n=11; 92%). Three (20%) were randomized control studies. While the rate of newly diagnosed HIV cases varied widely (0.03-2.2%), likely due to methodological heterogeneity between studies, the linkage of new HIV diagnosis was often high (80-100%) and median CD4+ cell count was always greater than 200 cells per microliter. Targeted HIV screening was found to be cost-effective (out of 2 studies) and well accepted by participants (out 2 studies). Conclusions: Targeted HIV screening at the ED can be impactful, feasible and well accepted, but often requires extra funding and staff. Most previous work has focused on areas of high disease prevalence.

scholarly journals Prediction of Cost-effectiveness for Human Immunodeficiency Virus (HIV) Screening Program in Japan

1995 ◽  
Vol 5 (1) ◽  
pp. 35-41
Author(s):  
Mahbubur Rahman ◽  
Takashi Tsutsui ◽  
Isao Kamae ◽  
Takashi Takahashi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Hiv Screening ◽  
Immunodeficiency Virus

scholarly journals 1061. False Positive Human Immunodeficiency Virus Testing Due to Acute Hepatitis A Infection: A Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S559-S559
Author(s):  
Maria V Bandres ◽  
Daniel Mueller
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Hepatitis ◽  
Hiv Testing ◽  
False Positive ◽  
Hepatitis A ◽  
Screening Tests ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Acute Hepatitis A ◽  
Hiv 1

Abstract Background In our urban, underserved patient population, Human Immunodeficiency Virus (HIV) is hyper-endemic, and HIV screening is frequently performed. Although HIV screening tests have high specificity, false positives can occur. Numerous reasons for false positive testing have been cited, including vaccinations, autoimmune diseases, and viral infections. In 2019, Philadelphia experienced a large Hepatitis A outbreak, during which time false positive HIV screening tests were discovered. Our aim was to further describe these patients who had been diagnosed with acute Hepatitis A infection and in whom false positive HIV testing had occurred. Methods We conducted a retrospective chart review of adult patients admitted to our hospital between January 2017 and December 2019 who had a positive Hepatitis A Virus (HAV) IgM. Demographics, HIV tests, viral hepatitis tests, and liver tests were recorded. False positive HIV was defined as a positive HIV screen (p24 antigen and HIV-1 and 2 antibody combo), followed by a negative differentiation assay for HIV-1 and 2 antibodies, combined with a negative HIV PCR. Results A total of 156 unique patients were found to have acute HAV, with 138 cases identified in 2019. Of these, 3 patients had confirmed false positive HIV testing, and 1 patient had suspected false positive HIV testing (HIV-2 differentiation assay indeterminate, with very low local prevalence of HIV-2), for a false positive test rate of 2.6% (4/156). Ages ranged from 36-47 years, 3 were male, and 2 were persons who injected drugs (PWID). Three patients had prior negative HIV testing. Two patients had fevers during admission, but none of the four were febrile at the time of HIV test collection. Three patients had elevated transaminases, and two had abnormal coagulation testing. Coinfection with Hepatitis C was found in three patients. One patient had follow-up HIV testing performed, which was negative. Conclusion To our knowledge, this is the first report of false positive HIV testing related to acute HAV. Prevalence of false positives was low, but awareness can facilitate patient counseling. With low sample size, conclusions cannot be drawn about risk factors related to false positive testing. Disclosures All Authors: No reported disclosures

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