Evaluation of a rapid point-of-care HIV screening program in an emergency department setting in Detroit, Michigan

Zhu, Weiming; Mumby, K.; Dankerlui, Doreen; Manteuffel, Jacob; Ham, Cal; Huang, Ya-Lin; Peters, Philip J.; Fakile, Yetunde; Markowitz, Norman; Hoover, Karen W.

doi:10.1016/j.jcv.2018.06.016

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…relacionadas con infección oculta: Resultados iniciales del programa "Urgències VIHgila" Ò. Miró, et al servicios de urgencias hospitalarios (SUH) [7][8][9][10][11][12]. Entre otras razones, el acceso al SUH es universal en la gran mayoría de países y, en muchos de ellos, supone además la única forma de acceso a la atención sanitaria de colectivos vulnerables entre los cuales la prevalencia de infección por VIH puede estar incrementada respecto a la población general.…”

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Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the “Urgències VIHgila” program

Miró¹,

Miró²,

Carbó³

et al. 2023

Rev Esp Quimioter

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Objective. To estimate the prevalence of unknown HIV infection in patients who consulted in hospital emergency services (ED) for conditions defined in the SEMES-GESIDA Consensus Document (DC), evaluate the efficiency of its im-plementation and investigate the efficiency of HIV serology determination in other conditions. Methods. Results were reviewed in 10 Catalan EDs for 12 months (July-21-June-22) after implementing CD recommendations: request HIV serology in case of suspected sexually transmitted infection, chemsex, post-exposure prophylaxis (PEP), mononucleosis syndrome, community pneumonia (18-65 y-o) or herpes zoster (18-65 y-o). Other reasons for request were included. Prevalence (%) of global seropositivity and for each circumstance was calculated, with a 95% confidence interval (95%CI). The efficient strategy was considered if the lower limit of the CI95%>0.1%. Results. A total of5,107 HIV serologies were performed: 2,847(56%) in situations specified in CD, and 2,266 (44%) in other 138 circumstances. Forty-eight unknown HIV infections were detected (prevalence=0.94%;95%CI=0.69-1.24). The prevalence was somewhat higher in DC requests (30 cas-es 1.12%) than the rest (18 cases 0.71%; p=0.16). The individualized prevalence of CD reasons ranged between 7.41% (95%CI=0.91-24.3) in chemsex and 0.42% 95%CI=0.14-0.98) in PPE, always efficient except herpes zoster (0.76%; CI95%=0.02-4.18). In other reasons, cases were detected in 12 circumstances, and in four the determination could be efficient: lymphopenia (10%;CI95%=0.25-44.5), fever with polyarthralgia-polyarthritis (7.41%;CI95% =0.91-24.3), behavioral alteration-confusion-encephalopathy (3.45%;95%CI=0.42-11.9) and fever of unknown origin (2.50%;95%CI=0.82-5.74). Conclusion. The determination of HIV serology in HES in the processes defined by DC SEMES-GESIDA is efficient. Some circumstances are identified that could be added to those previously contemplated to increase efficiency.

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Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the “Urgències VIHgila” program

Miró¹,

Miró²,

Carbó³

et al. 2023

Rev Esp Quimioter

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“…While much of the current literature on HIV testing in the emergency department is focused on either clinical prediction tools or 4th generation HIV testing, [20][21][22] we sought to assess clinical knowledge of both STIs and HIV in a survey study to explore clinical scenarios where HIV testing is either common or missed. The survey respondents in our study were a mix of attending physicians, resident physicians, and APPs, which reflects a similar distribution of providers in EDs across the nation.…”

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confidence: 99%

Clinical knowledge of human immunodeficiency virus and sexually transmitted infections among emergency medicine providers

et al. 2019

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Introduction This study examines the association of the domains of knowledge for HIV and sexually transmitted infections (STIs) among emergency medicine providers (EP). Methods From February 2018 to March 2018, 75 EP (physicians, residents, and advanced practice providers) completed an anonymous, self-administered survey. The primary outcome of strength of correlation between HIV and STI sections of the survey was analyzed using Spearman’s rank-order coefficient. Results Respondents were physicians (54.6%), male (56%), Caucasian (83.7%), with eight years in practice (IQR: 2,16). Spearman’s correlation of HIV and STIs showed a weak positive correlation ( r = 0.35, p = 0.002). There was no association between HIV scores and provider type ( p = 0.67) or provider gender ( p = 0.89) as well as no association between STI scores and provider type ( p = 0.10) or provider gender ( p = 0.79). Conclusion The results of our study reveal that when presented with a patient at high risk for undiagnosed HIV or with undiagnosed symptomatic HIV infection, most providers either do not test or do not have HIV in the differential diagnosis. Similarly, knowledge of STIs is only weakly correlated with knowledge of HIV risk factors and symptomatic HIV infection. Further research and screening efforts may benefit by focusing on HIV education among emergency medicine providers.

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“…Se identificaron un total de 273 artículos de los cuales 151 de ellos se excluyeron por ser registros duplicados entre las diferentes combinaciones de términos empleadas. De los 122 artículos restantes se excluyeron 110 por no cumplir con los criterios de inclusión, quedando 12 artículos (14 estudios) [12][13][14][15][16][17][18][19][20][21][22][23] . Dos artículos 20,21 aportan la información de 4 subestudios comparando dos estrategias de despistaje en dos periodos diferentes.…”

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Efficiency of screening for human immunodeficiency virus infection in emergency departments: a systematic review and meta-analysis

González del Castillo,

Fuentes Ferrer,

Fernández Pérez

et al. 2024

Emergencias

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Objetivo. Existe una elevada tasa de infección oculta y diagnóstico tardío en el virus de la inmunodeficiencia humana (VIH). La realización de pruebas diagnósticas de infección por VIH en los servicios de urgencias hospitalarios (SUH) puede representar una oportunidad para aumentar el número de diagnósticos. El objetivo de este trabajo es analizar si el cribado universal para el VIH realizado en los SUH es eficiente. Método. Se realiza una revisión sistemática y metanálisis siguiendo la normativa PRISMA en la base de datos de Pubmed, Cochrane, LILACS, Scopus, EMBASE y WOS utilizando una combinación de términos MESH: “HIV Infections/ epidemiology”, “AIDS Serodiagnosis”, “Emergency Service, Hospital”, “Prevalence”, “Mass screening/methods”. Los criterios de la búsqueda se centraron en los últimos 5 años (2016-2020) y en los artículos publicados en inglés y en español. Se incluyeron los estudios de pruebas de cribado universal mediante test de cribado de VIH realizadas en los SUH. Para evaluar la calidad de los artículos se utilizó el cuestionario “Quality assessment tool for quantitative studies”. Resultado. Se identificaron un total de 273 artículos de los cuales se analizaron finalmente 12 que cumplían los criterios de inclusión. Los estudios incluidos representan un total de 103.731 muestras analizadas obteniéndose un total de 652 nuevos diagnósticos de VIH. La prevalencia conjunta obtenida a través del modelo de efectos aleatorios fue de 0,60% (IC 95%: 0,39-0,84) y el valor del I2 revela una presencia elevada de heterogeneidad (I2 90,02%; p < 0,001). La prevalencia conjunta en los estudios incluidos realizados en Europa, América y África fue de 0,48% (IC 95%: 0,13- 1,03), 0,54% (IC 95%: 0,33-0,40) y 5,6% (IC 95%: 3,37-9,2), respectivamente. La evaluación de la calidad de los estudios fue de moderada a fuerte. Conclusiones. Aunque las pruebas del VIH pueden realizarse utilizando diferentes estrategias, nuestros datos avalan que una estrategia de cribado universal es eficiente

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Evaluation of a rapid point-of-care HIV screening program in an emergency department setting in Detroit, Michigan

Cited by 4 publications

References 3 publications

Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the “Urgències VIHgila” program

Emergency detection of HIV infection in patients consulting for conditions potentially related to occult infection: Initial results of the “Urgències VIHgila” program

Clinical knowledge of human immunodeficiency virus and sexually transmitted infections among emergency medicine providers

Efficiency of screening for human immunodeficiency virus infection in emergency departments: a systematic review and meta-analysis

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