TY - JOUR
T1 - Multicenter HIV and hepatitis B seroprevalence study
AU - Jui, Jonathan
AU - Modesitt, Steve
AU - Fleming, David
AU - Stevens, Penny
AU - Wayson, Barbara
AU - Hulman, Sharon
AU - Schriverz, John A.
PY - 1990
Y1 - 1990
N2 - Prior single institutional investigations have found unrecognized HIV seroprevalence in emergency department (ED) patients to range from 0.38% to 4%. A prospective, anonymous study of HIV and hepatitis B (HB) seroprevalence was performed on excess serum of all ED patients over two 48-hour periods in May and August, 1988, from 7 hospitals in the Portland metropolitan area. Demographics were known for 338/444 (76%) of patients. Forty-six percent were male, 85 % white, with a median age group of 34-39 years. Ambulance transport, trauma, external blood, presentations requiring ED procedure(s), and acuity resulting in ICU admission were present on 21%, 7%, 10%, 34%, and 14% of patients, respectively. Two of 444 (.45%) patients were HIV +, one previously undiagnosed. Fifty-five of the 444 (12%) and 3 of 444 (0.6%) samples were positive for HBcAB and HBsAG respectively. Risk factor assessment was possible on 180/444 (40%) patients. HBcAB seroprevalence correlated with race (P < 0.01), IV drug use (P < 0.0001), and hospital location, (P < 0.006) but were sensitive in detecting only 14%, 18%, and 38%, respectively, of HBcAB+ patients. HBcAB was not associated with the following factors: sex, area of residence, presence of blood externally, trauma, acuity of illness, ED procedures, or mode of transport. This data strongly support the use of universal body fluid precautions. Hepatitis B poses a significant and distinct risk to all emergency care providers. HB vaccination should be strongly advocated for all ED health care workers (HCWs). Emergency medicine multicenter studies are both desirable and feasible.
AB - Prior single institutional investigations have found unrecognized HIV seroprevalence in emergency department (ED) patients to range from 0.38% to 4%. A prospective, anonymous study of HIV and hepatitis B (HB) seroprevalence was performed on excess serum of all ED patients over two 48-hour periods in May and August, 1988, from 7 hospitals in the Portland metropolitan area. Demographics were known for 338/444 (76%) of patients. Forty-six percent were male, 85 % white, with a median age group of 34-39 years. Ambulance transport, trauma, external blood, presentations requiring ED procedure(s), and acuity resulting in ICU admission were present on 21%, 7%, 10%, 34%, and 14% of patients, respectively. Two of 444 (.45%) patients were HIV +, one previously undiagnosed. Fifty-five of the 444 (12%) and 3 of 444 (0.6%) samples were positive for HBcAB and HBsAG respectively. Risk factor assessment was possible on 180/444 (40%) patients. HBcAB seroprevalence correlated with race (P < 0.01), IV drug use (P < 0.0001), and hospital location, (P < 0.006) but were sensitive in detecting only 14%, 18%, and 38%, respectively, of HBcAB+ patients. HBcAB was not associated with the following factors: sex, area of residence, presence of blood externally, trauma, acuity of illness, ED procedures, or mode of transport. This data strongly support the use of universal body fluid precautions. Hepatitis B poses a significant and distinct risk to all emergency care providers. HB vaccination should be strongly advocated for all ED health care workers (HCWs). Emergency medicine multicenter studies are both desirable and feasible.
KW - Etiology
KW - HIV seropositivity
KW - Transmission Acquired
KW - acquired immunodeficiency syndrome
KW - antibodies, viral analysis
KW - diagnosis
KW - emergency service, hospital
KW - epidemiology
KW - occupational diseases
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U2 - 10.1016/0736-4679(90)90001-C
DO - 10.1016/0736-4679(90)90001-C
M3 - Article
C2 - 2197320
AN - SCOPUS:0025036308
SN - 0736-4679
VL - 8
SP - 243
EP - 251
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 3
ER -