{
  "abstract": "Background Late diagnosis of HIV, HBV and HCV remains a major public health challenge. Emergency Departments (ED) provide a setting for opportunistic screening, although implementation is influenced by organisational constraints, staffing requirements and regulatory frameworks that continue to differentiate HIV from other infections. The Progresso-T project evaluated the feasibility, uptake and diagnostic yield of bundled testing for HIV, HBV and HCV in an ED in Rome.Methods Adult ED attendees were approached for HIV, HBV, HCV testing during predefined time slots across different days of the week. Testing was offered by dedicated personnel external to routine ED clinical staff. Written informed consent in multiple languages was required for HIV testing in accordance with national legislation. Rapid tests were performed on residual whole blood recovered from routine haematology testing, allowing screening to be completed without additional phlebotomy. Data collected included test uptake, availability of residual samples, test results (anti-HIV, HBsAg, anti-HCV), demographics and reasons for refusal.Results In this ongoing project, among 519 patients (53.6% men) offered bundled testing, 396 (76.3%) accepted ( figure 1). Individuals who accepted testing were younger than those who declined (mean age 53 vs 60 years; p=0.006), while acceptance did not differ by sex (men 78.1% vs women 78.5%; p=0.99). The highest acceptance rates (>90%) were in the periods 09:00-12:00 and 15:00-21:00. Among consenting individuals, residual samples were available for 353/396 (89.1%). For the remaining 43/396 (10.9%) without residual samples, 34/43 (79.1%) were successfully contacted by telephone to alert them to this; 9 (20.9%) could not be reached despite repeated attempts. Among 353 tested individuals, we identified 1 with HIV (0.3%), 2 with HBsAg (0.6%), and 6 with anti-HCV (1.7%) (figure 1). Notably, 5/6 individuals with anti-HCV were born outside the national birth-cohort 1969-1989 screening target. Among the 123 patients who declined testing, 62.6% did not provide a specific reason, refusing to sign the HIV consent form; reported reasons included recent prior testing (17.1%), perceived absence of risk (12.2%), lack of interest in participation (6.5%) and fear of receiving a positive result (1.6%).Conclusions Bundled HIV, HBV and HCV testing in the ED using residual samples is feasible but is constrained by HIV-specific consenting processes and requires dedicated personnel. Uptake was high, and younger age and time of attendance were associated with higher acceptance. The identification of individuals with anti-HCV largely outside the national birth-cohort highlights the added value of ED-based opportunistic screening in reaching individuals not captured by existing strategies. Harmonisation and simplification of consent requirements across infections, together with integration into routine ED workflows, is critical to achieving scalable and equitable screening.Abstract SC29 Figure 1Study flow",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "M Leone"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "F Cecilia"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "S Ciarpaglini"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "E Perugini"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy"
      ],
      "name": "D Meloni"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy"
      ],
      "name": "L Benedetti"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "A Giovannelli"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "M Pelagalli"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "F Tomassetti"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy"
      ],
      "name": "D Zace"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "A di Lorenzo"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Emergency Department, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "JM Legramante"
    },
    {
      "affiliations": [
        "Emergency Department, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "C Paganelli"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "V Malagnino"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "S Bernardini"
    },
    {
      "affiliations": [
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "M Pieri"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "L Sarmati"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "AM Geretti"
    },
    {
      "affiliations": [
        "Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy",
        "Department of Infectious Diseases, Tor Vergata University Hospital, Rome, Italy",
        "Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy",
        "Department of Laboratory Medicine, Tor Vergata University Hospital, Rome, Italy",
        "Emergency Department, Tor Vergata University Hospital, Rome, Italy"
      ],
      "name": "PROGRESSO-T (Promuoviamo maggiore accesso ai test) Study Team"
    }
  ],
  "title": "SC29 Implementation of emergency department bundled testing for HIV, HBV and HCV using residual samples: the Progresso-T project",
  "uid": "b11f1e4d-a539-5e58-b8b4-c099e82234ee"
}