Human immunodeficiency virus and hepatitis testing and prevalence among surgical patients in an urban university hospital

Eric S. Weiss, Edward E. Cornwell, Theresa Wang, Dora Syin, E. Anne Millman, Peter J. Pronovost, David Chang, Martin A Makary

Research output: Contribution to journalArticle

Abstract

Background: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant public health problems in an urban community. Early diagnosis and treatment of these infections can improve survival and allow for preventive strategies to reduce further transmission within a community. The aim of this study was to evaluate the surgical setting as a potential opportunity for early diagnosis of HIV, hepatitis B, and hepatitis C among trauma and non-trauma patients. Methods: We performed a retrospective review of patients presenting for surgery over a 10-year period (July 1994 to July 2004) in an urban, university-based general surgical practice that includes all trauma services, as well as emergency department, inpatient, and outpatient surgical consultations. Data collected included diagnosis, operation, age, race, history of intravenous drug abuse, and HIV, hepatitis B, and hepatitis C test results. Results: Among 2876 patients presenting for surgery, testing for blood-borne pathogens was less likely among trauma patients (21%, 79/380) compared to non-trauma patients (47%, 1183/2496) (P <.001). Among patients tested, the incidence of blood-borne pathogens was similar in the two groups: HIV (26% trauma vs 24% non-trauma, not significant [NS]), hepatitis B (4% trauma vs 3% non-trauma, NS), hepatitis C (33% trauma vs 41% non-trauma, NS), and co-infection with HIV and hepatitis C (18% trauma vs 12% non-trauma, NS). In both groups, blood-borne pathogens were associated with intravenous drug abuse (P <.01). Conclusion: HIV, hepatitis B, and hepatitis C are common in an urban community among both trauma and non-trauma surgical patients, although testing is less common among trauma patients. Testing of patients during a surgical admission may represent an excellent opportunity for early disease-specific services and preventive interventions.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalAmerican Journal of Surgery
Volume193
Issue number1
DOIs
StatePublished - Jan 2007

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Urban Hospitals
Hepatitis
HIV
Hepatitis C
Hepatitis B
Wounds and Injuries
Blood-Borne Pathogens
Intravenous Substance Abuse
Early Diagnosis
Coinfection
General Practice
Hospital Emergency Service
Inpatients
Outpatients
Referral and Consultation
Public Health
Survival
Incidence
Infection

ASJC Scopus subject areas

  • Surgery

Cite this

Human immunodeficiency virus and hepatitis testing and prevalence among surgical patients in an urban university hospital. / Weiss, Eric S.; Cornwell, Edward E.; Wang, Theresa; Syin, Dora; Millman, E. Anne; Pronovost, Peter J.; Chang, David; Makary, Martin A.

In: American Journal of Surgery, Vol. 193, No. 1, 01.2007, p. 55-60.

Research output: Contribution to journalArticle

Weiss, Eric S. ; Cornwell, Edward E. ; Wang, Theresa ; Syin, Dora ; Millman, E. Anne ; Pronovost, Peter J. ; Chang, David ; Makary, Martin A. / Human immunodeficiency virus and hepatitis testing and prevalence among surgical patients in an urban university hospital. In: American Journal of Surgery. 2007 ; Vol. 193, No. 1. pp. 55-60.
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abstract = "Background: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant public health problems in an urban community. Early diagnosis and treatment of these infections can improve survival and allow for preventive strategies to reduce further transmission within a community. The aim of this study was to evaluate the surgical setting as a potential opportunity for early diagnosis of HIV, hepatitis B, and hepatitis C among trauma and non-trauma patients. Methods: We performed a retrospective review of patients presenting for surgery over a 10-year period (July 1994 to July 2004) in an urban, university-based general surgical practice that includes all trauma services, as well as emergency department, inpatient, and outpatient surgical consultations. Data collected included diagnosis, operation, age, race, history of intravenous drug abuse, and HIV, hepatitis B, and hepatitis C test results. Results: Among 2876 patients presenting for surgery, testing for blood-borne pathogens was less likely among trauma patients (21{\%}, 79/380) compared to non-trauma patients (47{\%}, 1183/2496) (P <.001). Among patients tested, the incidence of blood-borne pathogens was similar in the two groups: HIV (26{\%} trauma vs 24{\%} non-trauma, not significant [NS]), hepatitis B (4{\%} trauma vs 3{\%} non-trauma, NS), hepatitis C (33{\%} trauma vs 41{\%} non-trauma, NS), and co-infection with HIV and hepatitis C (18{\%} trauma vs 12{\%} non-trauma, NS). In both groups, blood-borne pathogens were associated with intravenous drug abuse (P <.01). Conclusion: HIV, hepatitis B, and hepatitis C are common in an urban community among both trauma and non-trauma surgical patients, although testing is less common among trauma patients. Testing of patients during a surgical admission may represent an excellent opportunity for early disease-specific services and preventive interventions.",
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AU - Pronovost, Peter J.

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AB - Background: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant public health problems in an urban community. Early diagnosis and treatment of these infections can improve survival and allow for preventive strategies to reduce further transmission within a community. The aim of this study was to evaluate the surgical setting as a potential opportunity for early diagnosis of HIV, hepatitis B, and hepatitis C among trauma and non-trauma patients. Methods: We performed a retrospective review of patients presenting for surgery over a 10-year period (July 1994 to July 2004) in an urban, university-based general surgical practice that includes all trauma services, as well as emergency department, inpatient, and outpatient surgical consultations. Data collected included diagnosis, operation, age, race, history of intravenous drug abuse, and HIV, hepatitis B, and hepatitis C test results. Results: Among 2876 patients presenting for surgery, testing for blood-borne pathogens was less likely among trauma patients (21%, 79/380) compared to non-trauma patients (47%, 1183/2496) (P <.001). Among patients tested, the incidence of blood-borne pathogens was similar in the two groups: HIV (26% trauma vs 24% non-trauma, not significant [NS]), hepatitis B (4% trauma vs 3% non-trauma, NS), hepatitis C (33% trauma vs 41% non-trauma, NS), and co-infection with HIV and hepatitis C (18% trauma vs 12% non-trauma, NS). In both groups, blood-borne pathogens were associated with intravenous drug abuse (P <.01). Conclusion: HIV, hepatitis B, and hepatitis C are common in an urban community among both trauma and non-trauma surgical patients, although testing is less common among trauma patients. Testing of patients during a surgical admission may represent an excellent opportunity for early disease-specific services and preventive interventions.

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