title: [Proposal of HIV, HBV and HCV targeted screening: short period feasibility study in a free-access outpatient medical structure].
abstract: OBJECTIVE
  In France, patients coming from sub-Saharan Africa, French Indies and French Guiana are frequently missed HIV, HBV and HCV diagnosis, despite high prevalence of these infections.
  
  
  METHODS
  Targeted proposal of HIV, HBV and HCV screening, using sensitive enzyme immunoassays, to any adult patient originating of the above mentioned areas, with/without medical insurance, consulting for a medical issue in outpatients' department. Monocentric prospective study in a hospital in Paris during 28 consecutive days in 2010.
  
  
  RESULTS
  Among the 272 eligible patients, 166 were tested (patients' acceptance: 61%). 180/272 (66%) alleged being tested previously for HIV, women (66/87, 76%) more frequently than men (114/185, 62%), P=0.02. Patients' acceptance seemed higher in patients mentioning no previous test than in patients reporting previous test. Among the patients who refused being tested, reporting a previous negative HIV test, more than a quarter has been tested more than 1 year ago. Among the 166 tested patients, 120 (72%) came back to get their results, men (89/113, 79%) more frequently than women (31/53, 58.5%), P=0.009; recently metropolitan patients more frequently than longer metropolitan patients, P=0.01; patients without any job more frequently than patients with a job, P=0.01. Three (1.8%) HIV tests returned positive; HBsAg was positive in 13 (7.8%) patients; 54 patients (32.7%) had a negative hepatitis B screening (anti-HBcAb+HBsAg+anti-HBsAb), attesting to sensitivity to this infection, only 18 patients (10.9%) showed isolated anti-HBsAb at protective levels. Eighty-one patients (49.1%) exhibited anti-HBcAb, confirming the high prevalence of HBV infection in the areas the patients came from. Six patients (3.6%) had anti-HCVAb. There was no co-infection.
  
  
  CONCLUSIONS
  Targeted HIV, HBV and HCV screening to patients coming from high prevalence areas in outpatients' department appears a very cost-effective strategy.
authors.affiliation: Hôpital Lariboisière, urgences accueil et traitement des urgences, 75010 Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Aparicio
authors.forename: Thomas
authors.initials: T
authors.lastname: Mourez
authors.forename: Guy
authors.initials: G
authors.lastname: Simoneau
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Magnier
authors.forename: Bertrand
authors.initials: B
authors.lastname: Galichon
authors.forename: Patrick
authors.initials: P
authors.lastname: Plaisance
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bergmann
authors.forename: Pierre
authors.initials: P
authors.lastname: Sellier
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology; D006297:Health Services Accessibility / Q000458:organization & administration; D016174:Hepacivirus / Q000302:isolation & purification / Q000502:physiology; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D006515:Hepatitis B virus / Q000302:isolation & purification / Q000502:physiology; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012107:Research Design; D013997:Time Factors