APHL Asks For Help With HIV Algorithms
Back in 1989, the Centers for Disease Control and Prevention (CDC) and the Association of Public Health Laboratories (APHL) issued a firm algorithm for diagnosing HIV; an algorithm that is still in use today as the gold standard.
The patient is tested with a preliminary enzyme immunoassay (EIA) screening test. If the result is repeatedly reactive, the patient result is listed as "preliminary positive" and a blood specimen is further tested by a more specific test such as the Western Blot or an indirect immunofluorescence assay (IFA).
If the preliminary EIA test is negative, the patient is presumed to be negative, with no further testing needed.
Over the years, rapid tests have become more specific, sensitive and less complex. An oral specimen is now acceptable for some tests.
Public health authorities are encouraging that many more people get tested; not just those from the old so called "high risk groups." Tests therefore need to be accurate and fast and done in a way that will minimize hassle for patients, e.g. not requiring everyone to return for their results, or using 2 different EIA tests to produce a definitive result.
APHL issued the following release recently:
"The Association of Public Health Laboratories (APHL) has published 'HIV Testing Algorithms: A Status Report,' in collaboration with the Centers for Disease Control and Prevention. The report presents newly-proposed HIV testing strategies for both point-of-care and laboratory settings. The document's purpose is to facilitate the dissemination, evaluation and discussion of these alternative testing algorithms." You may read the executive summary here.
The release continues, " Data are requested from any laboratory using alternative HIV testing algorithms or evaluating the performance of multiple HIV tests. These data will be used to evaluate the performance of these alternative algorithms and, eventually, lead to the development of improved guidelines for HIV testing. Specific data needs are outlined in the report. To submit data, complete the data questionnaire or contact firstname.lastname@example.org."