HIV SEROPREVALENCE IN EMERGENCY DEPARTMENT PATIENTS - PORTLAND, OREGON, 1988-1991

Objectives: In Portland, OR: 1) to determine the changes in HIV seropr evalence for ED patients from 1988 to 1991, 2) to define the character istics of the HIV-positive ED patient, 3) to determine the hepatitis B seroprevalence of HIV-seropositive ED patients, and 4) to demonstrate the feasibility of an ED population-based surveillance investigation. Methods: A prospective, multiyear observational, cross-sectional, mul ticenter, population-based seroprevalence study was performed using se ven urban hospital EDs. Serologic testing for HIV and hepatitis B was performed on excess blood obtained from ED patients. Four sampling per iods were used at each hospital at 14-month intervals starting June 19 88 and ending December 1991. The blood specimens were obtained concurr ently at all the participating hospitals. Results: Of 1,681 patients, 17 (1.0%) were HIV-positive. The HIV seroprevalence rate was relativel y stable over time: 0.5% (2/444) in 1988, 1.7% (7/396) in 1989, 1% (3/ 296) in 1990, and 0.9% (5/545) in 1991. Most (94%) HIV patients were m en, 100% were white, 81% were greater than or equal to 30 years old. M ost (59%) of the HIV-positive patients also were positive for hepatiti s B core antibody. Many (76%) of the HIV-positive patients were known to be positive by the emergency health care worker. Conclusion: HIV se roprevalence among the ED patients in Portland, OR, was generally stab le from 1988 to 1998. Many HIV-positive patients also were hepatitis-B -positive, thus representing a double occupational infectious disease risk to ED personnel. A significant minority (24%) of the HIV-positive patients were not known to be HIV-positive by the ED personnel. Unive rsal precautions and hepatitis B immunization are paramount for reduci ng the risk of infectious disease due to exposure to body fluids.