PROPOSED HIV TEST ALGORITHMS FOR CONSIDERATION

Proposed Point of Care HIV Testing Algorithms        Proposed Laboratory-Based HIV Testing Algorithms

The HIV Steering Committee was created by the Association of Public Health Laboratories (APHL) and the Centers for Disease Control and Prevention (CDC) in January 2004 to facilitate improved communication between the CDC and public health laboratories (PHL). This Steering Committee monitors key HIV diagnostic testing issues, evaluates emerging concerns; and develops recommendations and guidelines as needed.

National guidelines to confirm HIV-1 infection by the Western blot (WB) and indirect immunofluorescence assay (IFA) have remained largely unchanged since they were originally established through the CDC and the Association of State and Territorial Public Health Laboratory Directors (now APHL) consensus processes in the late 1980s. Therefore the APHL/CDC HIV Steering Committee has made updating and revising the current HIV testing guidelines a priority.

In August 2006, the Steering Committee formed two multi-disciplinary workgroups to address this priority. Both workgroups were tasked with developing the best combination of tests for use in the laboratory and at the point of care (POC) to determine HIV infection status. The laboratory HIV algorithms workgroup includes representatives from APHL, American Society for Microbiology, blood banks, CDC, College of American Pathologists, Department of Defense, Food and Drug Administration (FDA), and commercial, clinical and public health laboratories. The POC HIV algorithms workgroup is comprised of representatives from APHL, CDC, FDA, National Alliance of State and Territorial AIDS Directors, state and local public health laboratories, and HIV prevention programs.

Over the past year, the laboratory algorithms workgroup developed several strategies for HIV testing, including those that address acute HIV infection (Strategy 4) and HIV-2 detection (Strategy 5). Similarly the POC algorithms workgroup has developed potential strategies for the sequential use of up to three rapid HIV tests outside laboratory settings, at sites such as STD clinics, physician offices, and mobile clinics.

These proposed testing strategies have been used to outline the call for abstracts for the 2007 HIV Diagnostics Conference. We are soliciting data that will be used to encourage further development of these strategies, accompanying guidelines, reporting language and counselor messages which are appropriate for laboratorians, health care providers, HIV counselors and individuals receiving HIV test results. Data gaps identified at the conference will also guide development of a monitoring and evaluation plan for implementation of the strategies, guidelines and messaging.

Note that the publication of the strategies on this site is for the purposes of soliciting data and engaging in scientific discourse at the 2007 HIV Diagnostics conference, and does not constitute final recommendations or guidance on the use of these alternative HIV testing strategies.

This information is distributed solely for the purpose of pre-dissemination public comment. It does not represent and should not be construed to represent any official determination or policy of the APHL, CDC or any of the agencies represented in the workgroups.