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Proposed HIV Test Algorithms
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Objective and Goal
The objective of the 2007 HIV Diagnostics Conference was to facilitate presentation and discussion on the performance and applications of proposed HIV test algorithms drafted by APHL/CDC workgroups.  The goal of the conference was to provide information for the development of APHL/CDC guidelines on the combinations of assays that can be used to aid in the diagnosis of HIV-1 and/or HIV-2 infection in community, clinical, and laboratory settings in the United States.

Background
National guidelines to confirm HIV-1 infection by the Western blot (WB) and indirect immunofluorescence assay (IFA) has remained unchanged since the late 1980s.  Compared with newer assays, the WB and IFA are less sensitive to detect recent HIV infection, are more costly, and may require more laboratory expertise and time to perform.  Since 2003, two third-generation enzyme immunoassays (EIA), six rapid tests, and a nucleic acid amplification test (NAAT) have been FDA-approved for diagnostic use in the United States.  Several of these new assays are also approved to detect antibodies to HIV-2.  Existing national guidelines do not address the application of these newer assays to help diagnose HIV-1 and HIV-2 infection.  Compared with the current WB/IFA confirmatory algorithm, combinations of newer generation immunoassays and NAAT may identify some infections earlier; reduce testing costs; permit HIV-2 detection; reduce provision of false-positive, false-negative, and indeterminate test results; and increase the proportion of HIV-infected clients who learn their results and who are linked to appropriate care. Information on the performance and application of these new technologies, when used in combinations, is needed to help develop national guidelines on alternative diagnostic algorithms for HIV-1/2 infection in the United States.

Audience
The conference was attended by clinicians, laboratorians, program managers, directors, and industry representatives who help provide HIV testing services in the United States.