NYC Shows the Importance of HIV, Hepatitis C Screenings in the ER

Out of the 4,990 completed tests for HIV, 308 patients were repeatedly reactive on screening. Two hundred and forty-eight patients were reactive with supplemental testing and two patients had antibody-negative/RNA positive acute HIV infections—bringing the total to 250 HIV-positive ER visitors (5%). However, only 12 were actually undiagnosed (seven males, five females). Seven of the undiagnosed patients were ages 40 to 59.

The researchers found anti-HCV antibody in 372 of 4,989 participants (7.5%) with completed results. The confirmatory test showed HCV RNA positive in 196 individuals—38 of which (19.2%) of which were undiagnosed.

There was also a substantial number of coinfections in the cohort. Of HIV-positive individuals, 32% had anti-HCV antibody; 21% who were anti-HCV positive had HIV. In addition, 16% of those with HIV were HCV RNA positive; 19% of HCV RNA positive also had HIV.

The prevalence of HIV and the number of undiagnosed cases were actually the lowest in the history of serosurveys conducted in NYC ERs. HCV prevalence and undiagnosed cases, however, were higher in this serosurvey than what officials estimated citywide. Perhaps not so surprisingly was that baby boomers had the highest HCV prevalence in the study. Age clusters 40 to 59 and 70 to 89 also had high rates.

This study shows undiagnosed patients on a localized scale, but the Centers for Disease Control and Prevention (CDC) estimates that 13% of people with HIV and 50% of people with hepatitis C worldwide aren’t aware of their positive status.

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