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14,800 tested for infectious diseases at St James’s ED

Fifteen new cases of HIV have been diagnosed; as well as 21 new cases of hepatitis B; and 57 new cases of hepatitis C.

St James’s Hospital conducts routine opt-out testing for all three infections to diagnose new cases and link disengaged patients back to care. Recent studies show that at least 2 per 1,000 people in the Dublin area have been diagnosed with HIV infection.

The hospital, which treats over 46,000 patients within the ED annually, conducted an opt-out pilot screening programme in March 2014 for patients who were having blood tests taken in the ED.

During that pilot phase, 10,000 samples were obtained over a 44-week testing period. Results identified high rates of new HIV, hepatitis B and C infection. At the time of the pilot, almost 30 per cent of people already diagnosed with hepatitis C were not receiving care.

Since opt-out testing for these infections began one year ago, as part of routine care for those patients having blood tests taken in the ED, high rates of new infection have again been found. These patients often do not realise they have an infection of this kind and would not otherwise undergo testing. Patients are promptly linked to care for support and treatment following diagnosis.

Speaking today on World Hepatitis Day, Consultant in Infectious Diseases at St James’s Hospital Prof Colm Bergin commented: “The routine testing programme that commenced in July of last year clearly demonstrates high prevalence rates for all three infections in attendees of our Emergency Department and we find it alarming to continue to find the high numbers of new diagnoses.

“Not knowing you are infected may mean disease progression for years before effective treatment. Not only will this harm the infected person, but it may allow transmission to others when each is unaware of the risk of infection from a seemingly healthy partner

“The commencement of routine testing for HIV, hepatitis B and hepatitis C has provided us with a unique opportunity to both diagnose those with no perceived infection risk and to link those disengaged patients back to care. This policy is expected to reduce the human cost of these diseases, as well as the healthcare costs.”

The extension to routine testing in the ED for three blood-borne viral infections is supported by the HSE Acute Hospitals Division and the Population Health and Wellbeing Directorate.

Implementation of the programme is the result of a successful collaboration between the Departments of GU Medicine and Infectious Diseases, Emergency Medicine, Hepatology and Microbiology, the Irish Hepatitis C Outcomes research Network (ICORN), the Infectious Diseases Society of Ireland (IDSI), HSE social inclusion unit and pharmaceutical partners who helped fund the pilot study.

Meanwhile, ICORN has announced an award of two research scholarships to graduates worth €100,000. The two graduates, who have excelled in their academia, will each undertake a two-year scholarship programme worth €25,000 per annum to contribute towards maintenance, fees and other consumables.

Launched in early 2016, the ICORN HCV Research Scholarship Programme awards candidates who wish to undertake a research degree at MD, PhD or MSc level in the field of HCV, the opportunity to do so at their chosen university or institute in Ireland alongside a supervisor from the ICORN Network. ICORN invited applications from interested candidates early this year and reported significant interest in the programme.

Following a selection process chaired by Dr Diarmaid Houlihan, Consultant Hepatologist and Chair of the ICORN Research Group, Therese Herlihy and Nicole Walsh were selected as the recipients of the ICORN HCV Research Scholarships: the ICORN-ABBVIE HCV Research Scholarship and the ICORN-BMS HCV Research Scholarships respectively.

Therese Herlihy will commence her scholarship and PhD in UCD this month. The title of her project is, “A prospective, observational cohort study investigating the radiographic and clinical outcomes associated with treatment of chronic Hepatitis C infection with directly acting antiviral agents in cirrhotic subjects.” Therese’s project will be supervised by ICORN members Dr Steve Stewart from the Mater Misericordiae University Hospital and Dr Aoife Cotter from UCD.

Nicole Walsh will commence her scholarship and MSc Degree in UCC in October. The title of her project is, “Epitope Mapping of the E2 Glycoprotein, including the Hypervariable Region 1, of the Hepatitis C Virus Genotype 3a, in the context of Humoral Immune Pressure.” Nicole’s project will be supervised by ICORN members Dr Liam Fanning from UCC and Prof Cliona O’Farrelly from Trinity College, Dublin.

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