title: Incorporating HIV/hepatitis B virus/hepatitis C virus combined testing into routine blood tests in nine UK Emergency Departments: the "Going Viral" campaign.
abstract: OBJECTIVE
  Routine HIV screening is recommended in those UK hospitals and primary care settings where the HIV prevalence is > 0.2%. For hepatitis B virus (HBV) and hepatitis C virus (HCV), however, testing is targeted at at-risk groups. We investigated the prevalence of these blood-borne viruses (BBVs) during a routine testing pilot in UK Emergency Departments (EDs).
  
  
  METHODS
  During the "Going Viral" campaign (13-19 October 2014), nine UK EDs in areas of high HIV prevalence offered routine tests for HIV, HBV and HCV to adults having blood taken as part of routine care. Patients who tested positive were linked to care.
  
  
  RESULTS
  A total of 7807 patients had blood taken during their ED visit; of these, 2118 (27%) were tested for BBVs (range 9-65%). Seventy-one BBV tests were positive (3.4%) with 32 (45.1%) new diagnoses. There were 39 HCV infections (15 newly diagnosed), 17 HIV infections (six newly diagnosed), and 15 HBV infections (11 newly diagnosed). Those aged 25-54 years had the highest prevalence: 2.46% for HCV, 1.36% for HIV and 1.09% for HBV. Assuming the cost per diagnosis is £7, the cost per new case detected would be £988 for HCV, £1351 for HBV and £2478 for HIV.
  
  
  CONCLUSIONS
  In the first study in the UK to report prospectively on BBV prevalence in the ED, we identified a high number of new viral hepatitis diagnoses, especially hepatitis C, in addition to the HIV diagnoses. Testing for HIV alone would have missed 54 viral hepatitis diagnoses (26 new), supporting further evaluation of routine BBV testing in UK EDs.
authors.affiliation: Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Orkin
authors.affiliation: Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Flanagan
authors.affiliation: Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Wallis
authors.affiliation: Public Health England, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Ireland
authors.affiliation: Sexual Health Department, Barking, Havering and Redbridge NHS Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Dhairyawan
authors.affiliation: Sexual Health Department, Kings College Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Fox
authors.affiliation: Sexual Health Department, NHS Greater Glasgow and Clyde, Glasgow, UK.
authors.forename: R
authors.initials: R
authors.lastname: Nandwani
authors.affiliation: Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: O'Connell
authors.affiliation: Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lascar
authors.affiliation: Sexual Health Department, Leeds Teaching Hospital, Leeds, UK.
authors.forename: J
authors.initials: J
authors.lastname: Bulman
authors.affiliation: Sexual Health Department, Homerton University Hospital, London, UK.
authors.forename: I
authors.initials: I
authors.lastname: Reeves
authors.affiliation: Sexual Health Department, University Hospital of Leicester NHS Trust, Leicester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Palfreeman
authors.affiliation: Hepatology Department, Queen Mary University London, London, UK.
authors.forename: G R
authors.initials: GR
authors.lastname: Foster
authors.affiliation: Emergency Department, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Ahmad
authors.affiliation: Public Health England, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Virology Department, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: C Y W
authors.initials: CY
authors.lastname: Tong
authors.affiliation: Public Health England, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Lattimore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001769:Blood / Q000821:virology*; D042241:Early Diagnosis; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D006509:Hepatitis B / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Emergency Department; HIV testing; blood-borne virus seroprevalence; blood-borne virus testing; hepatitis C testing