title: High Feasibility of Empiric HIV Treatment for Patients With Suspected Acute HIV in an Emergency Department.
abstract: Earlier intervention in acute HIV infection limits HIV reservoirs and may decrease HIV transmission. We developed criteria for empiric antiretroviral therapy (ART) in an emergency department (ED) routine HIV screening program. We assessed the feasibility and willingness of patients with suspected acute HIV infection in the ED to begin ART. A suspected acute HIV infection was defined as a positive HIV antigen antibody combination immunoassay with pending HIV-antibody differentiation test results and HIV RNA viral load. During the study period, there were 16 confirmed cases of acute HIV infection: 11 met our criteria for empiric ART and agreed to treatment, 10 were prescribed ART, and 1 left the ED against medical advice without a prescription for ART. Eight patients completed at least one follow-up visit. Empiric HIV treatment in an ED is feasible, well received by patients, and offers a unique entry point into the HIV care continuum.
authors.affiliation: University of Southern California, Keck School of Medicine, Los Angeles, CA.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Jacobson
authors.forename: Sanjay
authors.initials: S
authors.lastname: Arora
authors.forename: Kristin B
authors.initials: KB
authors.lastname: Walsh
authors.forename: Meredith
authors.initials: M
authors.lastname: Lora
authors.forename: Stephen
authors.initials: S
authors.lastname: Merjavy
authors.forename: Shanna
authors.initials: S
authors.lastname: Livermore
authors.forename: Michael
authors.initials: M
authors.lastname: Menchine
mesh_terms: D018791:CD4 Lymphocyte Count; D003266:Continuity of Patient Care; D003955:Diagnostic Tests, Routine; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000523:psychology; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008403:Mass Screening; D010865:Pilot Projects; D014481:United States; D019562:Viral Load