Blood-bourne viruses (BBV) such as HIV, HBV, and HCV cause significant morbidity and mortality worldwide, with HCV and HBV combined causing 3500 deaths per day. Despite significant breakthroughs in the recent decade regarding the treatment of these diseases, the rate of new diagnoses have remained relatively static, suggesting the presence of a large population of undiagnosed viraemic patients who have yet to undergo treatment. It is thought that a significant number of BBV-infected patients are unaware of their diagnosis, which contributes substantially to the onward transmission of the BBVs. Currently, the Emergency Department Viral Screening (EDVS) programme in St. James Hospital utilizes opt-out BBV screening for patients undergoing routine phlebotomy in the emergency department (ED) in order to improve detection rates and access to early treatment. This research project aims to expand the EDVS to include opt-out BBV screening for patients in the outpatient department (OPD) undergoing routine phlebotomy, as well as offering opt-in BBV screens to patients not undergoing routine phlebotomy within in the ED if they have not been screened in the last 6 months, or are identified to be at high-risk for BBVs.
This prospective implementational study has two main objectives. Firstly, it acts to demonstrate the feasibility, acceptance, and effectiveness of implementing BBV screening methods in the OPD and ED. This will be done largely through a 3-month interim analysis looking at clearly-defined endpoints such as diagnostic rates and acceptance rates of the new screening programme in the total eligible population. Secondly, it aims to establish new BBV diagnoses, reduce onward community transmission of BBVs, and link patients with appropriate care for early treatment and diagnosis.