دورية أكاديمية
أعرض في EDS

Real-world clinical effectiveness and sustainability of universal bloodborne virus testing in an urban emergency department in the UK.

التفاصيل البيبلوغرافية
العنوان: Real-world clinical effectiveness and sustainability of universal bloodborne virus testing in an urban emergency department in the UK.
المؤلفون: Smout E; UK Field Epidemiology Training Programme, UK Health Security Agency, Leeds, UK.; Field Service, UK Health Security Agency, Leeds, UK., Phyu K; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Hughes GJ; Field Service, UK Health Security Agency, Leeds, UK., Parker L; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Rezai R; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Evans A; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., McLaren J; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Bush S; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Davey S; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Aldersley MA; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK., Ruf M; Public Health, Medical Affairs, Gilead Sciences Ltd, London, UK., Page EE; Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George St, Leeds, LS1 3EX, UK. emma.page7@nhs.net.
المصدر: Scientific reports [Sci Rep] 2022 Nov 10; Vol. 12 (1), pp. 19257. Date of Electronic Publication: 2022 Nov 10.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : Nature Publishing Group, copyright 2011-
مواضيع طبية MeSH: HIV Infections*/diagnosis , HIV Infections*/epidemiology , Hepatitis C*/diagnosis , Hepatitis C*/epidemiology , Hepatitis B*/diagnosis , Hepatitis B*/epidemiology, Humans ; Hepatitis B Surface Antigens ; Seroepidemiologic Studies ; Hepacivirus ; Emergency Service, Hospital ; Treatment Outcome ; United Kingdom ; RNA
مستخلص: Innovative testing approaches and care pathways are required to meet HIV, hepatitis B (HBV) and hepatitis C (HCV) elimination goals. Routine testing for blood-borne viruses (BBVs) within emergency departments (EDs) is suggested by the European Centre for Disease Prevention and Control but there is a paucity of supporting evidence. We evaluated the introduction of routine BBV testing in EDs at a large teaching hospital in northern England. In October 2018, we modified the electronic laboratory ordering system to reflex opt-out HIV, HBV and HCV testing for all ED attendees aged 16-65 years who had a routine blood test for urea and electrolytes (U&Es). Linkage to care (LTC) was attempted for newly diagnosed patients, those never referred and those who had previously disengaged from care. The project operated for 18 months, here we present evaluation of the initial nine months (2 October 2018-1 July 2019). We analysed testing uptake, BBV seropositivity, LTC and treatment initiation within six months post-diagnosis. Over 9 months, 17,026/28,178 (60.4%) ED attendees who had U&Es performed were tested for ≥ 1 BBV. 299 active BBV infections were identified: 70 HIV Ab/Ag-positive (0.4% seroprevalence), 73 HBsAg-positive (0.4%) and 156 HCV RNA-positive (1.0%). Only 24.3% (17/70) HIV Ab/Ag-positive individuals required LTC, compared to 94.9% (148/156) HCV RNA-positive and 53.4% (39/73) HBsAg-positive individuals. LTC was successful in 94.1% (16/17) HIV Ab/Ag-positive and 69.3% (27/39) HBsAg-positive individuals. However, at 6 months LTC was just 39.2% (58/148) for HCV RNA-positive individuals, with 64% (37/58) of these commencing treatment. Universal opt-out ED BBV testing proved feasible and effective in identifying active BBV infections, especially among marginalised populations with reduced healthcare access. Our integrated approach achieved good LTC rates although further service development is necessary, particularly for HCV RNA-positive people who inject drugs.
(© 2022. The Author(s).)
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المشرفين على المادة: 0 (Hepatitis B Surface Antigens)
63231-63-0 (RNA)
تواريخ الأحداث: Date Created: 20221110 Date Completed: 20221114 Latest Revision: 20230106
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9648896
DOI: 10.1038/s41598-022-23602-1
PMID: 36357472
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-2322
DOI:10.1038/s41598-022-23602-1