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Grant C, O'Connell S, Lillis D, Moriarty A, Fitzgerald I, Dalby L, Bannan C, Tuite H, Crowley B, Plunkett P, Kennedy U, McMahon G, McKiernan S, Norris S, Hughes G, Shields D, Bergin C, Opt-out screening for HIV, hepatitis B and hepatitis C: observational study of screening acceptance, yield and treatment outcomes, Emerg Med J, 2019,
Notes: [Abstract BACKGROUND: We initiated an emergency department (ED) opt-out screening programme for HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) at our hospital in Dublin, Ireland. The objective of this study was to determine screening acceptance, yield and the impact on follow-up care. METHODS: From July 2015 through June 2018, ED patients who underwent phlebotomy and could consent to testing were tested for HIV, HBV and HCV using an opt-out approach. We examined acceptance of screening, linkage to care, treatment and viral suppression using screening programme data and electronic health records. The duration of follow-up ranged from 1 to 36 months. RESULTS: Over the 36-month study period, there were 140 550 ED patient visits, of whom 88 854 (63.2%, 95% CI 63.0% to 63.5%) underwent phlebotomy and 54 817 (61.7%, 95% CI 61.4% to 62.0%) accepted screening for HIV, HBV and HCV, representing 41 535 individual patients. 2202 of these patients had a positive test result. Of these, 267 (12.1%, 95% CI 10.8% to 13.6%) were newly diagnosed with an infection and 1762 (80.0%, 95% CI 78.3% to 81.7%) had known diagnoses. There were 38 new HIV, 47 new HBV and 182 new HCV diagnoses. 81.5% (95% CI 74.9% to 87.0%) of known patients who were not linked were relinked to care after screening. Of the new diagnoses, 86.2% (95% CI 80.4 to 90.8%) were linked to care. CONCLUSION: Although high proportions of patients had known diagnoses, our programme was able to identify many new infected patients and link them to care, as well as relink patients with known diagnoses who had been lost to follow-up.],
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O'Connell S, Lillis D, Cotter A, O'Dea S, Tuite H, Fleming C, Crowley B, Fitzgerald I, Dalby L, Barry H, Shields D, Norris S, Plunkett PK, Bergin C., Opt-Out Panel Testing for HIV, Hepatitis B and Hepatitis C in an Urban Emergency Department: A Pilot Study, PLoS One, 11, (3), 2016,
Notes: [OBJECTIVES: Studies suggest 2 per 1000 people in Dublin are living with HIV, the level above which universal screening is advised. We aimed to assess the feasibility and acceptability of a universal opt-out HIV, Hepatitis B and Hepatitis C testing programme for Emergency Department patients and to describe the incidence and prevalence of blood-borne viruses in this population. METHODS: An opt-out ED blood borne virus screening programme was piloted from March 2014 to January 2015. Patients undergoing blood sampling during routine clinical care were offered HIV 1&2 antibody/antigen assay, HBV surface antigen and HCV antibody tests. Linkage to care where necessary was co-ordinated by the study team. New diagnosis and prevalence rates were defined as the new cases per 1000 tested and number of positive tests per 1000 tested respectively. RESULTS: Over 45 weeks of testing, of 10,000 patient visits, 8,839 individual patient samples were available for analysis following removal of duplicates. A sustained target uptake of >50% was obtained after week 3. 97(1.09%), 44(0.49%) and 447(5.05%) HIV, Hepatitis B and Hepatitis C tests were positive respectively. Of these, 7(0.08%), 20(0.22%) and 58(0.66%) were new diagnoses of HIV, Hepatitis B and Hepatitis C respectively. The new diagnosis rate for HIV, Hepatitis B and Hepatitis C was 0.8, 2.26 and 6.5 per 1000 and study prevalence for HIV, Hepatitis B and Hepatitis C was 11.0, 5.0 and 50.5 per 1000 respectively. CONCLUSIONS: Opt-out blood borne viral screening was feasible and acceptable in an inner-city ED. Blood borne viral infections were prevalent in this population and newly diagnosed cases were diagnosed and linked to care. These results suggest widespread blood borne viral testing in differing clinical locations with differing population demographic risks may be warranted.],
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Kieran JA, Norris S, O'Leary A, Walsh C, Merriman R, Houlihan D, McCormick PA, McKiernan S, Bergin C, Barry M, Hepatitis C in the era of direct-acting antivirals: real-world costs of untreated chronic hepatitis C; a cross-sectional study., BMC infectious diseases, 15, 2015, p471 ,
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S O'Connell, Lillis D, O'Dea S, H Tuite, C Fleming, D Shields, S Norris, B Crowley. P Plunkett, C Bergin , Results of a Universal Testing Programme for Blood Borne Viruses in an Urban Emergency Department, including Rates of Diagnosis and Linkage to Care, AASLD The Liver Meeting, Boston, MA, November 7-11 2014, 2014,
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Kieran J, Schmitz S, O'Leary A, Walsh C, Bergin C, Norris S, Barry M, The relative efficacy of boceprevir and telaprevir in the treatment of hepatitis C virus genotype 1., Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 56, (2), 2013, p228-35 ,
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Ní Cheallaigh C, Fitzgerald I, Grace J, Jagjit Singh G, El-Eraki N, Gibbons N, Keane J, Rogers TR, Clarke S, Bergin C, Interferon Gamma Release Assays for the Diagnosis of Latent TB Infection in HIV-Infected Individuals in a Low TB Burden Country., PloS one, 8, (1), 2013, pe53330 ,
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Morley D, McNamara P, Kennelly S, McMahon G, Bergin C, Limitations to the identification of HIV-associated neurocognitive disorders in clinical practice., HIV medicine, 14, (8), 2013, p497-502 ,
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Dillon AA, Farrell G, Hegarty JE, O'Grady JG, Norris S, Bergin C, The advent of successful organ transplantation in the Irish HIV positive cohort., Irish Journal of Medical Science, 181, (1), 2012, p49-52 ,
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De Gascun CF, Waters A, Regan C, O'Halloran J, Farrell G, Coughlan S, Bergin C, Powderly WG, Hall WW, Documented prevalence of HIV type 1 antiretroviral transmitted drug resistance in Ireland from 2004 to 2008., AIDS Research and Human Retroviruses, 28, (3), 2012, p276-81 ,
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Breslin TM, Ionmhain UN, Bergin C, Gallagher D, Collins N, Kinsella N, McMahon G, Malarial cases presenting to a European urban Emergency Department., European Journal of Emergency Medicine : official journal of the European Society for Emergency Medicine, 2012,
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