Date of this Version
Journal of Acquired Immune Deficiency Syndromes
The hospital laboratory performed round-the-clock rapid HIV antibody testing on venipuncture specimens from patients undergoing HIV testing in hospital and community clinics, inpatient settings, and the emergency department. For patients with negative results, a public health laboratory conducted pooled HIV RNA testing for acute HIV infection. The laboratories communicated positive results from the hospital campus to a linkage team. Linkage was defined as one outpatient HIV-related visit.
Among 7,927 patients, 8,550 rapid tests resulted in 137 cases of HIV infection (1.7%, 95% CI 1.5%–2.0%), of whom 46 were new HIV diagnoses (0.58%, 95% CI 0.43%–0.77%). Pooled HIV RNA testing of 6,704 specimens (78.4%) resulted in 3 cases of acute HIV infection (0.05%, 95% CI 0.01%–0.14) and increased HIV case detection by 3.5%. Half of new HIV diagnoses and 2/3 of acute infections were detected in the emergency department and urgent care clinic. Rapid test sensitivity was 98.9% (95% CI 93.8%– 99.8%); specificity was 99.9% (95% CI 99.7%–99.9%). Over 95% of newly diagnosed and out-of-care HIV-infected patients were linked to care.
Patients undergoing HIV testing in emergency departments and urgent care clinics may benefit from being simultaneously screened for acute HIV infection.
This is a non-final version of an article published in final form at J Acquir Immune Defic Syndr. Feb 1, 2013; 62(2): e30–e38. doi: 10.1097/QAI.0b013e31827a0b0d
HIV serodiagnosis; HIV rapid tests; acute HIV infection; HIV testing in medical settings
Christopoulos, Katerina A.; Zetola, Nicola M.; Klausner, Jeffrey D.; Haller, Barbara; Louie, Brian; Hare, Bradley; Pandori, Mark; Nassos, Patricia; Roemer, Marguerite; and Pilcher, Christopher D., "Leveraging a Rapid, Round-the-Clock HIV Testing System to Screen for Acute HIV Infection in a Large Urban Public Medical Center" (2013). Botswana-UPenn Scholarly Publications. 22.
Date Posted: 13 November 2014
This document has been peer reviewed.