Undiagnosed HIV and HCV infection in a New York City emergency department, 2015

Lucia V. Torian, Uriel R. Felsen, Qiang Xia, Fabienne Laraque, Eric J. Rude, Herbert Rose, Adam Cole, Angelica Bocour, Gary J. Williams, Robert F. Bridgforth, Lisa A. Forgione, Howard Doo, Sarah L. Braunstein, Demetre C. Daskalakis, Barry S. Zingman

Research output: Contribution to journalComment/debate

4 Citations (Scopus)

Abstract

Objectives. To measure undiagnosed HIV and HCV in a New York City emergency department (ED). Methods. We conducted a blinded cross-sectional serosurvey with remnant serum from specimens originally drawn for clinical indications in the ED. Serum was dedupli-cated and matched to (1) the hospital’s electronic medical record and (2) the New York City HIV and HCV surveillance registries for evidence of previous diagnosis before being deidentified and tested for HIV and HCV. Results. The overall prevalence of HIV was 5.0% (250/4990; 95% confidence interval [CI] = 4.4%, 5.7%); the prevalence of undiagnosed HIV was 0.2% (12/4990; 95% CI = 0.1%, 0.4%); and the proportion of undiagnosed HIV was 4.8% (12/250; 95% CI = 2.5%, 8.2%). The overall prevalence of HCV (HCV RNA ‡ 15 international units per milliliter) was 3.9% (196/4989; 95% CI = 2.8%, 5.1%); the prevalence of undiagnosed HCV was 0.8% (38/ 4989; 95% CI = 0.3%, 1.3%); and the proportion of undiagnosed HCV was 19.2% (38/196; 95% CI = 11.4%, 27.0%). Conclusions. Undiagnosed HCV was more prevalent than undiagnosed HIV in this population, suggesting that aggressive testing initiatives similar to those directed toward HIV should be mounted to improve HCV diagnosis.

Original languageEnglish (US)
Pages (from-to)652-658
Number of pages7
JournalAmerican Journal of Public Health
Volume108
Issue number5
DOIs
StatePublished - May 1 2018

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HIV Infections
Hospital Emergency Service
HIV
Confidence Intervals
Electronic Health Records
Serum
Registries
RNA
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Undiagnosed HIV and HCV infection in a New York City emergency department, 2015. / Torian, Lucia V.; Felsen, Uriel R.; Xia, Qiang; Laraque, Fabienne; Rude, Eric J.; Rose, Herbert; Cole, Adam; Bocour, Angelica; Williams, Gary J.; Bridgforth, Robert F.; Forgione, Lisa A.; Doo, Howard; Braunstein, Sarah L.; Daskalakis, Demetre C.; Zingman, Barry S.

In: American Journal of Public Health, Vol. 108, No. 5, 01.05.2018, p. 652-658.

Research output: Contribution to journalComment/debate

Torian, LV, Felsen, UR, Xia, Q, Laraque, F, Rude, EJ, Rose, H, Cole, A, Bocour, A, Williams, GJ, Bridgforth, RF, Forgione, LA, Doo, H, Braunstein, SL, Daskalakis, DC & Zingman, BS 2018, 'Undiagnosed HIV and HCV infection in a New York City emergency department, 2015', American Journal of Public Health, vol. 108, no. 5, pp. 652-658. https://doi.org/10.2105/AJPH.2018.304321
Torian, Lucia V. ; Felsen, Uriel R. ; Xia, Qiang ; Laraque, Fabienne ; Rude, Eric J. ; Rose, Herbert ; Cole, Adam ; Bocour, Angelica ; Williams, Gary J. ; Bridgforth, Robert F. ; Forgione, Lisa A. ; Doo, Howard ; Braunstein, Sarah L. ; Daskalakis, Demetre C. ; Zingman, Barry S. / Undiagnosed HIV and HCV infection in a New York City emergency department, 2015. In: American Journal of Public Health. 2018 ; Vol. 108, No. 5. pp. 652-658.
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abstract = "Objectives. To measure undiagnosed HIV and HCV in a New York City emergency department (ED). Methods. We conducted a blinded cross-sectional serosurvey with remnant serum from specimens originally drawn for clinical indications in the ED. Serum was dedupli-cated and matched to (1) the hospital’s electronic medical record and (2) the New York City HIV and HCV surveillance registries for evidence of previous diagnosis before being deidentified and tested for HIV and HCV. Results. The overall prevalence of HIV was 5.0{\%} (250/4990; 95{\%} confidence interval [CI] = 4.4{\%}, 5.7{\%}); the prevalence of undiagnosed HIV was 0.2{\%} (12/4990; 95{\%} CI = 0.1{\%}, 0.4{\%}); and the proportion of undiagnosed HIV was 4.8{\%} (12/250; 95{\%} CI = 2.5{\%}, 8.2{\%}). The overall prevalence of HCV (HCV RNA ‡ 15 international units per milliliter) was 3.9{\%} (196/4989; 95{\%} CI = 2.8{\%}, 5.1{\%}); the prevalence of undiagnosed HCV was 0.8{\%} (38/ 4989; 95{\%} CI = 0.3{\%}, 1.3{\%}); and the proportion of undiagnosed HCV was 19.2{\%} (38/196; 95{\%} CI = 11.4{\%}, 27.0{\%}). Conclusions. Undiagnosed HCV was more prevalent than undiagnosed HIV in this population, suggesting that aggressive testing initiatives similar to those directed toward HIV should be mounted to improve HCV diagnosis.",
author = "Torian, {Lucia V.} and Felsen, {Uriel R.} and Qiang Xia and Fabienne Laraque and Rude, {Eric J.} and Herbert Rose and Adam Cole and Angelica Bocour and Williams, {Gary J.} and Bridgforth, {Robert F.} and Forgione, {Lisa A.} and Howard Doo and Braunstein, {Sarah L.} and Daskalakis, {Demetre C.} and Zingman, {Barry S.}",
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T1 - Undiagnosed HIV and HCV infection in a New York City emergency department, 2015

AU - Torian, Lucia V.

AU - Felsen, Uriel R.

AU - Xia, Qiang

AU - Laraque, Fabienne

AU - Rude, Eric J.

AU - Rose, Herbert

AU - Cole, Adam

AU - Bocour, Angelica

AU - Williams, Gary J.

AU - Bridgforth, Robert F.

AU - Forgione, Lisa A.

AU - Doo, Howard

AU - Braunstein, Sarah L.

AU - Daskalakis, Demetre C.

AU - Zingman, Barry S.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Objectives. To measure undiagnosed HIV and HCV in a New York City emergency department (ED). Methods. We conducted a blinded cross-sectional serosurvey with remnant serum from specimens originally drawn for clinical indications in the ED. Serum was dedupli-cated and matched to (1) the hospital’s electronic medical record and (2) the New York City HIV and HCV surveillance registries for evidence of previous diagnosis before being deidentified and tested for HIV and HCV. Results. The overall prevalence of HIV was 5.0% (250/4990; 95% confidence interval [CI] = 4.4%, 5.7%); the prevalence of undiagnosed HIV was 0.2% (12/4990; 95% CI = 0.1%, 0.4%); and the proportion of undiagnosed HIV was 4.8% (12/250; 95% CI = 2.5%, 8.2%). The overall prevalence of HCV (HCV RNA ‡ 15 international units per milliliter) was 3.9% (196/4989; 95% CI = 2.8%, 5.1%); the prevalence of undiagnosed HCV was 0.8% (38/ 4989; 95% CI = 0.3%, 1.3%); and the proportion of undiagnosed HCV was 19.2% (38/196; 95% CI = 11.4%, 27.0%). Conclusions. Undiagnosed HCV was more prevalent than undiagnosed HIV in this population, suggesting that aggressive testing initiatives similar to those directed toward HIV should be mounted to improve HCV diagnosis.

AB - Objectives. To measure undiagnosed HIV and HCV in a New York City emergency department (ED). Methods. We conducted a blinded cross-sectional serosurvey with remnant serum from specimens originally drawn for clinical indications in the ED. Serum was dedupli-cated and matched to (1) the hospital’s electronic medical record and (2) the New York City HIV and HCV surveillance registries for evidence of previous diagnosis before being deidentified and tested for HIV and HCV. Results. The overall prevalence of HIV was 5.0% (250/4990; 95% confidence interval [CI] = 4.4%, 5.7%); the prevalence of undiagnosed HIV was 0.2% (12/4990; 95% CI = 0.1%, 0.4%); and the proportion of undiagnosed HIV was 4.8% (12/250; 95% CI = 2.5%, 8.2%). The overall prevalence of HCV (HCV RNA ‡ 15 international units per milliliter) was 3.9% (196/4989; 95% CI = 2.8%, 5.1%); the prevalence of undiagnosed HCV was 0.8% (38/ 4989; 95% CI = 0.3%, 1.3%); and the proportion of undiagnosed HCV was 19.2% (38/196; 95% CI = 11.4%, 27.0%). Conclusions. Undiagnosed HCV was more prevalent than undiagnosed HIV in this population, suggesting that aggressive testing initiatives similar to those directed toward HIV should be mounted to improve HCV diagnosis.

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U2 - 10.2105/AJPH.2018.304321

DO - 10.2105/AJPH.2018.304321

M3 - Comment/debate

VL - 108

SP - 652

EP - 658

JO - American Journal of Public Health

JF - American Journal of Public Health

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