Three Years of Shared Service HIV Nucleic Acid Testing for Public Health Laboratories: Worthwhile for HIV-1 but Not for HIV-2. (May 2020)

• Record Type: Journal Article
• Authors: Styer, Linda M.; Gaynor, Anne M.; Parker, Monica M.; Bennett, S. Berry; Wesolowski, Laura G.; Ethridge, Steven; Chavez, Pollyanna R.; Sullivan, Timothy J.; Fordan, Salvacion; Wroblewski, Kelly
• Is Part Of: Sexually transmitted diseases. Volume 47(2020)Supplement 1 5S
• Publication Date: 2020-05
• Subjects: Sexually transmitted diseases -- Periodicals; Sexual health -- Periodicals; 616.951005
• DOI: 10.1097/OLQ.0000000000001123
• Languages: English
• ISSNs: 0148-5717

Abstract

Abstract : Background: In 2016, HIV-2 nucleic acid testing (NAT) was added to a shared service program that conducts HIV-1 NAT for public health laboratories performing the recommended algorithm for diagnosing HIV. Here, we evaluate the usefulness of HIV-2 NAT in this program as compared with HIV-1 NAT. Methods: Specimens eligible for HIV-1 NAT were reactive on an HIV-1/2 antibody or antigen/antibody initial test and nonreactive or indeterminate on a supplemental antibody test or were reactive for HIV-1 antigen-only on an HIV-1/2 antigen/antibody initial test. Specimens eligible for HIV-2 NAT were reactive on an initial test, HIV-2 indeterminate or HIV indeterminate on a supplemental antibody test and had no detectable HIV-1 RNA or were reactive for HIV-2 antibody on an HIV-1/2 antigen/antibody test, and this reactivity was not confirmed with a supplemental antibody assay. All specimens were tested in a reference laboratory using APTIMA HIV-1 qualitative RNA and/or a validated qualitative HIV-2 RNA real-time PCR assay. Results: During 2016 to 2019, HIV-1 RNA was detected in 234 (14%) of 1731 specimens tested. HIV-2 RNA was not detected in 52 specimens tested. Median time from specimen collection to reporting of HIV-1 and HIV-2 NAT results by year ranged from 9 to 10 days and from 22 to 27 days, respectively. Two specimens with HIV-2 indeterminate results on a supplemental antibody test had detectable HIV-1 RNA. Conclusions: A shared service model for HIV-1 NAT is both feasible and beneficial for public health laboratories. However, because no HIV-2 infections were detected, our data suggest that this program should reconsider the usefulness of HIV-2 NAT testing. Abstract : A shared service human immunodeficiency virus (HIV)-1/HIV-2 nucleic acid testing program for public health laboratories detected 234 acute HIV-1 infections among 1731 specimens tested; HIV-2 RNA was not detected in 52 specimens tested.