Human immunodeficiency virus and hepatitis testing and prevalence among surgical patients in an urban university hospital.
BACKGROUND
Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant public health problems in an urban community. Early diagnosis and treatment of these infections can improve survival and allow for preventive strategies to reduce further transmission within a community. The aim of this study was to evaluate the surgical setting as a potential opportunity for early diagnosis of HIV, hepatitis B, and hepatitis C among trauma and non-trauma patients.


METHODS
We performed a retrospective review of patients presenting for surgery over a 10-year period (July 1994 to July 2004) in an urban, university-based general surgical practice that includes all trauma services, as well as emergency department, inpatient, and outpatient surgical consultations. Data collected included diagnosis, operation, age, race, history of intravenous drug abuse, and HIV, hepatitis B, and hepatitis C test results.


RESULTS
Among 2876 patients presenting for surgery, testing for blood-borne pathogens was less likely among trauma patients (21%, 79/380) compared to non-trauma patients (47%, 1183/2496) (P < .001). Among patients tested, the incidence of blood-borne pathogens was similar in the two groups: HIV (26% trauma vs 24% non-trauma, not significant [NS]), hepatitis B (4% trauma vs 3% non-trauma, NS), hepatitis C (33% trauma vs 41% non-trauma, NS), and co-infection with HIV and hepatitis C (18% trauma vs 12% non-trauma, NS). In both groups, blood-borne pathogens were associated with intravenous drug abuse (P < .01).


CONCLUSIONS
HIV, hepatitis B, and hepatitis C are common in an urban community among both trauma and non-trauma surgical patients, although testing is less common among trauma patients. Testing of patients during a surgical admission may represent an excellent opportunity for early disease-specific services and preventive interventions.
Weiss
Eric S
ES
Department of Surgery, John Hopkins University School of Medicine, Baltimore, MD, USA. eweiss3@jhmi.edu
Cornwell
Edward E
EE
Wang
Theresa
T
Syin
Dora
D
Millman
E Anne
EA
Pronovost
Peter J
PJ
Chang
David
D
Makary
Martin A
MA
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control; D044383:Black People; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People; D014947:Wounds and Injuries / Q000453:epidemiology; D001741:Black or African American