Seroprevalence survey of BBV in Emergency Departments attendees
Research type
Research Study
Full title
An unlinked anonymous seroprevalence survey of blood-borne viruses among Emergency Department attendees
IRAS ID
163053
Contact name
Sema Mandal
Contact email
Sponsor organisation
Public Health England
Duration of Study in the UK
2 years, 8 months, 4 days
Research summary
An unlinked anonymous seroprevalence survey of blood-borne viruses among Emergency Department attendees
An estimated 214 000 and 180 000 people have chronic hepatitis C (HCV) and B (HBV) respectively in the UK and around 98 000 are living with human immunodeficiency virus (HIV).
The risk of these blood borne virus infections (BBV) is higher in certain ethnic groups. A large proportion of infected people are unaware of their diagnosis and appropriate identification and treatment of those infected is fundamental to interrupting the chain of transmission.Emergency Departments (ED) are important points to test and provide access to care for people at increased risk of these infections, including migrants, those not registered with a GP, those who are homeless or in vulnerable housing and people who inject drugs (PWID). Many may not self-identify as being at increased risk of BBVs or access routine health services so attendance at an ED may be their only interaction with the health service. Sentinel surveillance of BBV testing has recently shown higher positivity testing rates in ED than in other primary care settings. Combined with the large numbers of ED attendances, this suggests that EDs provide a unique setting to detect undiagnosed cases of BBV for onward referral for specialist management, particularly in hard to reach and vulnerable populations.
As part of a programme of work to assess the feasibility of BBV testing in EDs, we propose to conduct 1) an evidence review, 2) qualitative work on barriers and enablers to testing in ED settings and 3) an unlinked anonymous seroprevalence survey of BBV among ED attendees
Two EDs in London will collaborate with this study: Royal Free London NHS Foundation Trust and University College London Foundation Trust. The choice of these settings was based on the diverse populations they serve including many at risk of infection with BBVs and their high number of ED attendances.The remit of this application is the seroprevalence survey arm of the project. We will follow the unlinked anonymous testing approach for the seroprevalence survey using residual blood specimens (taken for other purposes) from patients attending EDs over 2 weeks in order to obtain approximately 2500 samples from each ED.
The main outcomes will be an estimate of the prevalence of HBV, HCV and HIV infections in patients attending ED, and demographic characteristics of all individuals attending the ED, the subset of those for whom remnant bloods were available and those with positive and negative results.REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
14/LO/2170
Date of REC Opinion
5 Dec 2014
REC opinion
Further Information Favourable Opinion