ScholarlyCommons

Title

Leveraging a Rapid, Round-the-Clock HIV Testing System to Screen for Acute HIV Infection in a Large Urban Public Medical Center

Author(s)

Katerina A. Christopoulos
Nicola M. Zetola, University of PennsylvaniaFollow
Jeffrey D. Klausner
Barbara Haller
Brian Louie
Bradley Hare
Mark Pandori
Patricia Nassos
Marguerite Roemer
Christopher D. Pilcher

Document Type

Journal Article

Date of this Version

2-1-2013

Publication Source

Journal of Acquired Immune Deficiency Syndromes

Volume

62

Issue

2

Start Page

e30

Last Page

e38

DOI

10.1097/QAI.0b013e31827a0b0d

Abstract

Methods

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.

Results

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.

Conclusions

Patients undergoing HIV testing in emergency departments and urgent care clinics may benefit from being simultaneously screened for acute HIV infection.

Copyright/Permission Statement

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

Keywords

HIV serodiagnosis; HIV rapid tests; acute HIV infection; HIV testing in medical settings

Recommended Citation

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.
https://repository.upenn.edu/botswana_schol/22