HIV Infection Among Patients in U.S. Acute Care Hospitals
Janssen, Robert S.
St. Louis, Michael E.
Satten, Glen A.
Critchley, Sara E.
Petersen, Lyle R.
Stafford, Randall S.
Ward, John W.
Hanson, Debra L.
Schable, Charles A.
Dondero, Timothy J.
New England Journal of Medicine. 1992 Aug 13; 327(7): 445-452.
Background: Routine, voluntary testing of hospital patients for the human immunodeficiency virus (HIV) has been proposed in order to identify those with early HIV infection in a setting where there is ready access to counseling, appropriate clinical referral, evaluation, and therapy. We studied the pattern of HIV infection among patients in 20 U.S. hospitals, in order to evaluate possible national strategies for the routine, voluntary HIV counseling and testing of hospital patients. Methods: Blood specimens remaining after clinical use from a systematically selected sample of patients at 20 hospitals in 15 U.S. cities were tested anonymously for antibody to HIV type 1 (HIV-1). Multivariate regression was used to determine which variables best predicted HIV seroprevalence in the individual hospitals. Using these data, we estimated the number of HIV-positive patients in all U.S. hospitals and considered the efficiency of routine counseling and testing in different subgroups of patients and hospitals....Conclusions: We estimate that about 225,000 HIV-positive persons were hospitalized in 1990, of whom only one-third were admitted for symptomatic HIV infection or AIDS. Routine, voluntary HIV testing of patients 15 to 54 years old in hospitals with 1 or more patients with newly diagnosed AIDS per 1000 discharges per year could potentially have identified as many as 110,000 patients with HIV infection that was previously unrecognized.
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