HIV seroprevalence in emergency department patients

Portland, Oregon, 1988-1991.

Jonathan Jui, P. Stevens, K. Hedberg, S. Modesitt

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVES: In Portland, OR: 1) to determine the changes in HIV seroprevalence for ED patients from 1988 to 1991, 2) to define the characteristics of the HIV-positive ED patient, 3) to determine the hepatitis B seroprevalence of HIV-seropositive ED patients, and 4) to demonstrate the feasibility of an ED population-based surveillance investigation. METHODS: A prospective, multiyear observational, cross-sectional, multicenter, population-based seroprevalence study was performed using seven urban hospital EDs. Serologic testing for HIV and hepatitis B was performed on excess blood obtained from ED patients. Four sampling periods were used at each hospital at 14-month intervals starting June 1988 and ending December 1991. The blood specimens were obtained concurrently at all the participating hospitals. RESULTS: Of 1,681 patients, 17 (1.0%) were HIV-positive. The HIV seroprevalence rate was relatively stable over time: 0.5% (2/444) in 1988, 1.7% (7/396) in 1989, 1% (3/296) in 1990, and 0.9% (5/545) in 1991. Most (94%) HIV patients were men, 100% were white, 81% were > or = 30 years old. Most (59%) of the HIV-positive patients also were positive for hepatitis B core antibody. Many (76%) of the HIV-positive patients were known to be positive by the emergency health care worker. CONCLUSION: HIV seroprevalence among the ED patients in Portland, OR, was generally stable from 1988 to 1991. Many HIV-positive patients also were hepatitis B-positive, thus representing a double occupational infectious disease risk to ED personnel. A significant minority (24%) of the HIV-positive patients were not known to be HIV-positive by the ED personnel. Universal precautions and hepatitis B immunization are paramount for reducing the risk of infectious disease due to exposure to body fluids.

Original languageEnglish (US)
Pages (from-to)773-783
Number of pages11
JournalAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine
Volume2
Issue number9
StatePublished - Sep 1995

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HIV Seroprevalence
Hospital Emergency Service
HIV
Hepatitis B
Communicable Diseases
Universal Precautions
Population Surveillance
Hepatitis B Antibodies
Occupational Diseases
Urban Hospitals
Seroepidemiologic Studies
Body Fluids
Emergency Medical Services
Immunization

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

HIV seroprevalence in emergency department patients : Portland, Oregon, 1988-1991. / Jui, Jonathan; Stevens, P.; Hedberg, K.; Modesitt, S.

In: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, Vol. 2, No. 9, 09.1995, p. 773-783.

Research output: Contribution to journalArticle

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title = "HIV seroprevalence in emergency department patients: Portland, Oregon, 1988-1991.",
abstract = "OBJECTIVES: In Portland, OR: 1) to determine the changes in HIV seroprevalence for ED patients from 1988 to 1991, 2) to define the characteristics of the HIV-positive ED patient, 3) to determine the hepatitis B seroprevalence of HIV-seropositive ED patients, and 4) to demonstrate the feasibility of an ED population-based surveillance investigation. METHODS: A prospective, multiyear observational, cross-sectional, multicenter, population-based seroprevalence study was performed using seven urban hospital EDs. Serologic testing for HIV and hepatitis B was performed on excess blood obtained from ED patients. Four sampling periods were used at each hospital at 14-month intervals starting June 1988 and ending December 1991. The blood specimens were obtained concurrently at all the participating hospitals. RESULTS: Of 1,681 patients, 17 (1.0{\%}) were HIV-positive. The HIV seroprevalence rate was relatively stable over time: 0.5{\%} (2/444) in 1988, 1.7{\%} (7/396) in 1989, 1{\%} (3/296) in 1990, and 0.9{\%} (5/545) in 1991. Most (94{\%}) HIV patients were men, 100{\%} were white, 81{\%} were > or = 30 years old. Most (59{\%}) of the HIV-positive patients also were positive for hepatitis B core antibody. Many (76{\%}) of the HIV-positive patients were known to be positive by the emergency health care worker. CONCLUSION: HIV seroprevalence among the ED patients in Portland, OR, was generally stable from 1988 to 1991. Many HIV-positive patients also were hepatitis B-positive, thus representing a double occupational infectious disease risk to ED personnel. A significant minority (24{\%}) of the HIV-positive patients were not known to be HIV-positive by the ED personnel. Universal precautions and hepatitis B immunization are paramount for reducing the risk of infectious disease due to exposure to body fluids.",
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