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Human immunodeficiency virus serology in a pediatric emergency department: reasons for ordering tests and the characteristics of positive cases

Fernández Díaz V, Ortigoza Escobar JD, Noguera Julián A, Fortuny Guasch C, Trenchs Sainz De La Maza V, Fernández Santervás Y

Servicio de Urgencias, 2Unidad de Infectología, Servicio de Pediatría, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain.

This study aimed to determine the most common reasons for ordering human
immunodeficiency virus (HIV) serology in a pediatric emergency department and to
describe the characteristics of HIV-positive cases. In 11 years, 933 HIV serologies were
ordered in the department. The most common reasons were protocols at the onset of
cancer or blood disease (40.1%), accidental puncture (17.8%), and high-risk sexual
intercourse (14.3%). The serology was positive in 4 cases (prevalence, 0.4%; 95% CI,
0.1%-1.1%). Three of the positive results were for children with a family history of HIV;
in the fourth positive case the patient had a mononucleosis-like syndrome and had had
high-risk sexual intercourse. Thus, most HIV serologies are performed to follow hospital
protocol rather than because there is clinical suspicion of HIV infection. The very few
patients who are diagnosed as HIV-positive in the pediatric emergency department have
family histories of seropositivity or have had high-risk intercourse.

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