A Different Form of Injury Prevention: Successful Screening and Referral for HIV and Hepatitis C in a Trauma Population

The Journal of Trauma and Acute Care Surgery
Benjamin WhiteLauren E Richey

Abstract

In the United States, millions of patients are living with HIV and Hepatitis C (0.44% and 1.5%) and many are currently undiagnosed. Since highly effective treatments are now available, early identification of these patients is extremely important to achieve improved clinical outcomes. Prior data and trauma-associated risk factors suggest a higher prevalence of both diseases in the trauma population. We hypothesized that a screening program could be successfully initiated amongst trauma activation patients and that a referral and linkage-to-care program could be developed. Hepatitis C and HIV screening tests were added to standard trauma activation lab orders at an academic Level 1 Trauma Center. Confirmatory viral load was sent when indicated. Patients with positive results were educated about their disease and referred to disease-specific follow-up. Data was collected prospectively from January 1, 2016 until June 30, 2017. Total and new diagnosis, referral rates, and linkage-to-care rates were analyzed. 1898 patients arrived as trauma activations. 1217 patients (64.1%) were screened (Level A = 75.6%, Level B = 60.2%). 7% of screened patients were initially positive and 5.5% were confirmed positive. Rates of both HIV (1.1%) and...Continue Reading

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