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CROI 2014: Success With ED Opt-Out HIV Testing

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The Particulars: Patients with acute HIV infection often seek medical care for their symptoms, presenting opportunities for intervention. Research has shown that fourth-generation technology for testing for HIV antigens and antibodies allows for the early diagnosis of HIV, particularly during the acute phase. Few studies have explored emergency department (ED) opt-out HIV screening using fourth-generation technology.

Data Breakdown: In a study, researchers found only 15% of nearly 25,000 patients actively opted out of an ED HIV screening program that used fourth-generation technology during the first 27 months of implementation of this screening strategy. Testing had a 0.28% positivity rate for previously undiagnosed cases of HIV infection, and about one-quarter of these cases involved patients with acute HIV infection.

Take Home Pearls: Routine opt-out HIV testing using fourth-generation technology in the ED setting appears to identify previously undiagnosed HIV in this population. This strategy may allow for early treatment and viral load suppression.

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