Journal article
Acute infections, cost and time to reporting of HIV test results in three U.S. State Public Health Laboratories
The Journal of infection, Vol.73(2), pp.164-172
08/2016
DOI: 10.1016/j.jinf.2016.05.006
PMCID: PMC4994193
PMID: 27237366
Abstract
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.
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.
Among 7914 specimens from Massachusetts PHL, 6069 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).
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.
Details
- Title: Subtitle
- Acute infections, cost and time to reporting of HIV test results in three U.S. State Public Health Laboratories
- Creators
- Muazzam Nasrullah - Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USALaura G Wesolowski - Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USASteven F Ethridge - Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USAKevin Cranston - Massachusetts Department of Public Health, Boston, MA, USAMichael Pentella - Massachusetts Department of Public Health, Boston, MA, USARobert A Myers - Maryland Department of HealthJames T Rudrik - Michigan Department of Health and Human Services, Lansing, MI, USAAngela B Hutchinson - Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USASpencer B Bennett - Florida Bureau of Public Health Laboratories, Jacksonville, FL, USABarbara G Werner - Massachusetts Department of Public Health, Boston, MA, USA
- Resource Type
- Journal article
- Publication Details
- The Journal of infection, Vol.73(2), pp.164-172
- DOI
- 10.1016/j.jinf.2016.05.006
- PMID
- 27237366
- PMCID
- PMC4994193
- NLM abbreviation
- J Infect
- ISSN
- 0163-4453
- eISSN
- 1532-2742
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 08/2016
- Academic Unit
- Central Control Hygienic Laboratory; Epidemiology
- Record Identifier
- 9983995131402771
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