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Acute Infections, Cost and Time to Reporting of HIV Test Results in Three U.S. State Public Health Laboratories
  • Published Date:
    May 26 2016
  • Source:
    J Infect. 73(2):164-172.


Public Access Version Available on: August 01, 2017 information icon
Please check back on the date listed above.
Details:
  • Pubmed ID:
    27237366
  • Pubmed Central ID:
    PMC4994193
  • Description:
    Objective

    In three U.S. state public health laboratories (PHLs) using a fourth-generation immunoassay (IA), an HIV-1/HIV-2 differentiation antibody IA and a nucleic acid test (NAT), we characterized the yield and time to reporting of acute infections, and cost per positive specimen.

    Methods

    Routine HIV testing data were collected from July 1, 2012-June 30, 2013 for Massachusetts and Maryland PHLs, and from November 27, 2012-June 30, 2013 for Michigan PHL. Massachusetts and Michigan used fourth-generation and differentiation IAs with NAT conducted by a referral laboratory. In Maryland, fourth-generation IA repeatedly reactive specimens were followed by a Western blot (WB), and those with negative or indeterminate results were tested with a differentiation IA and HIV-1 NAT, and if positive by NAT, confirmed by a different HIV-1 NAT. Specimens from WB-positive persons at risk for HIV-2 were tested with a differentiation IA and, if positive, with an HIV-2 WB and/or differential HIV-1/HIV-2 proviral DNA polymerase chain reaction.

    Results

    Among 7,914 specimens from Massachusetts PHL, 6,069 from Michigan PHL, and 36,266 from Maryland PHL, 0.10%, 0.02% and 0.05% acute infections were identified, respectively. Massachusetts and Maryland PHLs each had 1 HIV-2 positive specimen. The median time from specimen receipt to laboratory reporting of results for acute infections at Massachusetts, Michigan and Maryland PHLs was 8, 11, and 7 days respectively. The laboratory cost per HIV positive specimen was $336 (Massachusetts), $263 (Michigan) and $210 (Maryland).

    Conclusions

    Acute and established infections were found by PHLs using fourth-generation IA in conjunction with antibody tests and NAT. Time to reporting of acute HIV test results to clients was suboptimal, and needs to be streamlined to expedite treatment and interrupt transmission.

  • Document Type:
  • Collection(s):
  • Funding:
    CC999999/Intramural CDC HHS/United States
  • Supporting Files:
    No Additional Files
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