Debbie Y Mohammed1, Eugene Martin2, Charlotte Sadashige3, Michael Jaker4, Sindy Paul3. 1. St Michael's Medical Center, Department of Medicine, Division of Infectious Diseases, 111 Central Avenue, Newark, NJ 07101, United States; UMDNJ, New Jersey Medical School, Department of Medicine, 185 South Orange Avenue, Newark, NJ 07103, United States. Electronic address: mohammdy@umdnj.edu. 2. UMDNJ, Robert Wood Johnson Medical School, Department of Pathology and Laboratory Medicine, 1 World's Fair Drive, Somerset, NJ 08873, United States. 3. New Jersey Department of Health, Division of HIV, STD and TB Services, 50 East State Street, P.O. Box 363, Trenton, NJ 08625, United States. 4. UMDNJ, New Jersey Medical School, Department of Medicine, 185 South Orange Avenue, Newark, NJ 07103, United States.
Abstract
BACKGROUND: In 2002, the sero-prevalence of human immunodeficiency virus-1 (HIV) in the Emergency Department (ED), University Hospital, Newark, New Jersey was 10.4%. Both HIV and hepatitis C virus (HCV) are transmitted by injection drug use (IDU) or sexual contact. However, the degree of concurrent positive HCV antibody status in HIV-infected ED patients is unknown. OBJECTIVES: In this study we determined the sero-prevalence of HIV and HIVHCV in HIV-positive patients in the ED. STUDY DESIGN: A cross-sectional study using an anonymous sero-prevalence survey was conducted from 7/1/2008 to 8/23/2008. Medical records were reviewed and de-identified; remnant blood specimens were also de-identified and tested for HIV antibody, and if positive, HCV antibody. RESULTS: Of 3488 specimens, 225 (6.5%, 95% CI: 5.7-7.3%) were positive for HIV antibody. Seventy-four patients 74/225 (32.9%, 95% CI: 33.8-46.5%) were unaware of their sero-positivity. Forty percent of HIV positive patients (90/225, 95% CI: 33.8-46.5%) were HCV antibody positive. The highest seroprevalence of HIVHCV antibody was among older patients (≥ 45 years), and patients with positive urine toxicology and elevated liver function tests. DISCUSSION: Given the high prevalence of HIV and HIVHCV antibody in the ED, routine testing is important for patients ≥ 45 years with positive urine toxicology and elevated liver function tests.
BACKGROUND: In 2002, the sero-prevalence of human immunodeficiency virus-1 (HIV) in the Emergency Department (ED), University Hospital, Newark, New Jersey was 10.4%. Both HIV and hepatitis C virus (HCV) are transmitted by injection drug use (IDU) or sexual contact. However, the degree of concurrent positive HCV antibody status in HIV-infected EDpatients is unknown. OBJECTIVES: In this study we determined the sero-prevalence of HIV and HIVHCV in HIV-positivepatients in the ED. STUDY DESIGN: A cross-sectional study using an anonymous sero-prevalence survey was conducted from 7/1/2008 to 8/23/2008. Medical records were reviewed and de-identified; remnant blood specimens were also de-identified and tested for HIV antibody, and if positive, HCV antibody. RESULTS: Of 3488 specimens, 225 (6.5%, 95% CI: 5.7-7.3%) were positive for HIV antibody. Seventy-four patients 74/225 (32.9%, 95% CI: 33.8-46.5%) were unaware of their sero-positivity. Forty percent of HIV positive patients (90/225, 95% CI: 33.8-46.5%) were HCV antibody positive. The highest seroprevalence of HIVHCV antibody was among older patients (≥ 45 years), and patients with positive urine toxicology and elevated liver function tests. DISCUSSION: Given the high prevalence of HIV and HIVHCV antibody in the ED, routine testing is important for patients ≥ 45 years with positive urine toxicology and elevated liver function tests.
Authors: Eshan U Patel; Oliver Laeyendecker; Yu-Hsiang Hsieh; Richard E Rothman; Gabor D Kelen; Thomas C Quinn Journal: J Clin Virol Date: 2016-05-10 Impact factor: 3.168