Sistema de Salut de Catalunya
Institut Català de la Salut
[Smout E] Public Health, Gloucestershire NHS Trust, United Kingdom. [Ruf M] Public Health, Medical Affairs, Gilead Sciences Europe, London, United Kingdom. [Buti M] Servei d’Hepatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Vaz Pinto I] HIV Unit, Cascais Hospital, Cascais, Portugal. [Nebbia G] Department of Infection, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom. [Hunter L] Department of Emergency Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom. [Llaneras J] Servei d’Urgències, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-10-07T09:40:54Z
2025-10-07T09:40:54Z
2025-08
Virus; Blood; European emergency departments
Virus; Sang; Serveis d'urgències europeus
Virus; Sangre; Servicios de urgencias europeos
Innovative testing approaches are needed to meet global targets for the blood-borne viruses (BBVs) HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). We conducted a systematic review of BBV testing in emergency departments (EDs) in Europe to evaluate prevalence, effectiveness of ED testing and linkage to care (LTC). We searched PubMed, Embase and Cochrane Library for articles on ED BBV testing published between January 2012 and July 2022. Studies conducted outside Europe or prior to 2012 were excluded owing to epidemiological and healthcare service variation, together with studies that did not report core parameters. Reference lists from included articles were manually searched. Seventeen original articles met the inclusion criteria. Seven studies reported on HIV testing only. ED prevalence: HIV Ab, 0.0%-1.1%; HBsAg, 0.2%-0.9%; and HCV RNA, 0.2%-3.9%. BBV testing uptake varied by policy and offer methodology: opt-out, provider-initiated: 9.7%-44.2%; electronic health record (EHR) modification: 52.1%-88.9%; and opt-in, provider-initiated: 3.9%-37.7%. LTC rates were 8.1%-100% and varied by BBV, generally highest for HIV and lowest for HCV. There was variable detail in outcome reporting and description of clinical LTC pathways. ED BBV testing in Europe is feasible and identifies high numbers of infections (including, where reported, new diagnoses and disengaged patients), often among marginalized populations who use open-access EDs for healthcare. Factors associated with higher levels of sustained testing uptake included opt-out testing (vs opt-in), EHR (vs provider-initiated) and integration of community services. We propose a toolkit of components necessary for a high-performing ED BBV testing programme.
This work was supported by Medical Affairs, Gilead Sciences Europe.
Article
Published version
English
Hospitals - Serveis d'urgències; Cribatge (Medicina); Malalties transmissibles - Diagnòstic; Sang; DISEASES::Bacterial Infections and Mycoses::Infection::Communicable Diseases; HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Facilities::Health Facility Administration::Hospital Administration::Hospital Departments::Emergency Service, Hospital; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Mass Screening; ORGANISMS::Organism Forms::Blood-Borne Pathogens; ENFERMEDADES::infecciones bacterianas y micosis::infección::enfermedades transmisibles; ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::administración de establecimientos sanitarios::administración hospitalaria::departamentos hospitalarios::servicio hospitalario de urgencias; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::cribado sistemático; ORGANISMOS::formas de organismos::patógenos transmitidos por la sangre
Oxford University Press
European Journal of Public Health;35(4)
https://doi.org/10.1093/eurpub/ckaf103
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
