Outcomes 10 Years After Implementing an Emergency Department Opt-out Bloodborne Virus Screening Program.

Area of Science:

• Public Health
• Infectious Diseases
• Emergency Medicine

Background:

• Bloodborne viruses (BBV), including hepatitis B (HBV), hepatitis C (HCV), and HIV, present significant health risks.
• Screening and linkage to treatment are crucial for managing BBV and preventing transmission.
• This study evaluates a decade-long opt-out BBV screening program in an urban emergency department (ED).

Purpose of the Study:

• To assess the outcomes of a 10-year opt-out BBV screening program in an ED setting.
• To examine screening acceptance, new diagnoses, and linkage to care.
• To identify factors associated with new viremic HCV diagnoses to guide future services.

Main Methods:

• Routine BBV screening was offered to ED patients undergoing phlebotomy from July 2015.
• Data collected over 10 years included screening acceptance, new diagnoses, and linkage to care.
• Statistical analysis investigated factors linked to new viremic HCV diagnoses.

Main Results:

• Screening acceptance was high at 81% over the 10-year period.
• No significant changes in new HIV, HBV, or HCV diagnoses were observed, but a reduction in PCR-positive HCV was noted.
• Linkage to care was high: 96% for HIV, 89% for HBV, and 95% for HCV. PCR-positive HCV was associated with people who inject drugs and direct ED discharge.

Conclusions:

• ED-based BBV screening demonstrates sustained patient acceptability and detects new diagnoses.
• The program achieves high rates of linkage to care for BBV infections.
• Screening effectively identifies active HCV in specific populations, such as people who inject drugs, who are discharged directly from the ED.