{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:10:19Z","timestamp":1777486219307,"version":"3.51.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Innovative testing approaches and care pathways are required to meet HIV, hepatitis B (HBV) and hepatitis C (HCV) elimination goals. Routine testing for blood-borne viruses (BBVs) within emergency departments (EDs) is suggested by the European Centre for Disease Prevention and Control but there is a paucity of supporting evidence. We evaluated the introduction of routine BBV testing in EDs at a large teaching hospital in northern England. In October 2018, we modified the electronic laboratory ordering system to reflex opt-out HIV, HBV and HCV testing for all ED attendees aged 16\u201365\u00a0years who had a routine blood test for urea and electrolytes (U&amp;Es). Linkage to care (LTC) was attempted for newly diagnosed patients, those never referred and those who had previously disengaged from care. The project operated for 18\u00a0months, here we present evaluation of the initial nine months (2 October 2018\u20131 July 2019). We analysed testing uptake, BBV seropositivity, LTC and treatment initiation within six months post-diagnosis. Over 9\u00a0months, 17,026\/28,178 (60.4%) ED attendees who had U&amp;Es performed were tested for\u2009\u2265\u20091\u00a0BBV. 299 active BBV infections were identified: 70\u00a0HIV Ab\/Ag-positive (0.4% seroprevalence), 73 HBsAg-positive (0.4%) and 156 HCV RNA-positive (1.0%). Only 24.3% (17\/70) HIV Ab\/Ag-positive individuals required LTC, compared to 94.9% (148\/156) HCV RNA-positive and 53.4% (39\/73) HBsAg-positive individuals. LTC was successful in 94.1% (16\/17) HIV Ab\/Ag-positive and 69.3% (27\/39) HBsAg-positive individuals. However, at 6\u00a0months LTC was just 39.2% (58\/148) for HCV RNA-positive individuals, with 64% (37\/58) of these commencing treatment. Universal opt-out ED BBV testing proved feasible and effective in identifying active BBV infections, especially among marginalised populations with reduced healthcare access. Our integrated approach achieved good LTC rates although further service development is necessary, particularly for HCV RNA-positive people who inject drugs.<\/jats:p>","DOI":"10.1038\/s41598-022-23602-1","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T20:06:24Z","timestamp":1668110784000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Real-world clinical effectiveness and sustainability of universal bloodborne virus testing in an urban emergency department in the UK"],"prefix":"10.1038","volume":"12","author":[{"given":"Elizabeth","family":"Smout","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khine","family":"Phyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth J.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Parker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roozbeh","family":"Rezai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joscelyne","family":"McLaren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Bush","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Davey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Aldersley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murad","family":"Ruf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma E.","family":"Page","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,10]]},"reference":[{"key":"23602_CR1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS). 90-90-90: An ambitious treatment target to help end the AIDS epidemic. Geneva UNAIDS (2014)."},{"key":"23602_CR2","volume-title":"Global Health Sector Strategy on Viral Hepatitis 2016\u20132021","author":"World Health Organisation","year":"2016","unstructured":"World Health Organisation. Global Health Sector Strategy on Viral Hepatitis 2016\u20132021 (World Health Organisation, 2016)."},{"issue":"3","key":"23602_CR3","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1111\/hiv.12364","volume":"17","author":"C Orkin","year":"2016","unstructured":"Orkin, C. et al. Incorporating HIV\/hepatitis B virus\/hepatitis C virus combined testing into routine blood tests in nine UK Emergency Departments: the \u201cGoing Viral\u201d campaign. HIV Med. 17(3), 222\u2013230 (2016).","journal-title":"HIV Med."},{"issue":"27","key":"23602_CR4","first-page":"1800377","volume":"24","author":"N Bundle","year":"2019","unstructured":"Bundle, N. et al. Seroprevalence and demographic factors associated with hepatitis B, hepatitis C and HIV infection from a hospital emergency department testing programme, London, United Kingdom, 2015 to 2016. Euro Surveill. Bull. Eur. Mal. Transm. Eur. Commun. Dis. Bull. 24(27), 1800377 (2019).","journal-title":"Euro Surveill. Bull. Eur. Mal. Transm. Eur. Commun. Dis. Bull."},{"issue":"7","key":"23602_CR5","doi-asserted-by":"publisher","first-page":"e0198520","DOI":"10.1371\/journal.pone.0198520","volume":"13","author":"H Evans","year":"2018","unstructured":"Evans, H. et al. An innovative approach to increase viral hepatitis diagnoses and linkage to care using opt-out testing and an integrated care pathway in a London emergency department. 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All other authors report no potential competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19257"}}