Identifying Acute HIV Infections: Unexpected Benefit Of HIV Screening With A 4Th Generation Testing Platform
Methods: We conducted a retrospective review of the HIV testing program 15 months before and after converting from a point-of-care testing procedure to a lab-based 4thgeneration program (4/2012-9/2014). Our ED offers non-targeted testing of adult ED patients regardless of chief complaint. Acute HIV infection was defined as detectable HIV RNA or p24 antigen.
Results: HIV testing increased from 8,983 tests in the 15 months before the 4th generation testing to 22,593 in the 15 months after. Correspondingly, the number of newly diagnosed HIV+ individuals increased from 36 (0.4%) to 115 (0.5%). Zero acute HIV infections were identified prior to 4thgeneration testing while 14 acute HIV infections (12.2% of new infections) were diagnosed after. Acutely HIV-infected individuals had mean age of 34.8 years and 93% were male, 21.4% were African-American and 79% Latino. Median viral load in this group was 1.7 million copies/ml (3 cases had viral load >10 million copies/ml) and 85.6% of the patients attended at least one HIV-specific outpatient clinic visit.
Conclusion: Converting to a rapid, 4th generation HIV testing platform made critically-important acute HIV case identification feasible and resulted in identification of 14 acute cases in an urban ED setting.
Learning Areas:Administer health education strategies, interventions and programs
Administration, management, leadership
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Evaluate the impact of a lab-based 4th generation emergency department HIV screening program on the detection of acute HIV infection
Keyword(s): Prevention, HIV/AIDS
Qualified on the content I am responsible for because: I am the research project manager of this HIV testing program for the past four years. I received my master degree in public health, focusing on epidemiology and biostatistics. I am responsible for the data management, analysis and reporting of the HIV testing program to the local public health department.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.