Finding those at risk

Acute HIV infection in Newark, NJ

Eugene G. Martin, Gratian Salaru, Debbie Mohammed, Robert W. Coombs, Sindy M. Paul, Evan M. Cadoff

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: A screening strategy combining rapid HIV-1/2 (HIV) antibody testing with pooled HIV-1 RNA testing increases identification of HIV infections, but may have other limitations that restrict its usefulness to all but the highest incidence populations. Objective: By combining rapid antibody detection and pooled nucleic acid amplification testing (NAAT) testing, we sought to improve detection of early HIV-1 infections in an urban Newark, NJ hospital setting. Study design: Pooled NAAT HIV-1 RNA testing was offered to emergency department patients and outpatients being screened for HIV antibodies by fingerstick-rapid HIV testing. For those negative by rapid HIV and agreeing to NAAT testing, pooled plasma samples were prepared and sent to the University of Washington where real-time reverse transcription-polymerase chain reaction (RT-PCR) amplification was performed. Results: Of 13,226 individuals screened, 6381 had rapid antibody testing alone, and 6845 agreed to add NAAT HIV screening. Rapid testing identified 115 antibody positive individuals. Pooled NAAT increased HIV-1 case detection by 7.0% identifying 8 additional cases. Overall, acute HIV infection yield was 0.12%. While males represent only 48.1% of those tested by NAAT, all samples that screened positive for HIV-1 RNA were obtained from men. Conclusion: HIV-1 RNA testing of pooled, HIV antibody-negative specimens permits identification of recent infections. In Newark, pooled NAAT increased HIV-1 case detection and provided an opportunity to focus on treatment and prevention messages for those most at risk of transmitting infection. Although constrained by client willingness to participate in testing associated with a need to return to receive further results, use of pooled NAAT improved early infection sensitivity.

Original languageEnglish (US)
JournalJournal of Clinical Virology
Volume58
Issue numberSUPPL1
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Nucleic Acids
HIV Infections
HIV-1
HIV Antibodies
RNA
HIV
Antibodies
Infection
HIV-2
Reverse Transcription
Hospital Emergency Service
Outpatients
Polymerase Chain Reaction
Incidence
Population

Keywords

  • HIV screen
  • HIV seronegativity
  • HIV testing algorithms
  • NAAT
  • Nucleic acid amplification tests
  • Rapid HIV tests

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Finding those at risk : Acute HIV infection in Newark, NJ. / Martin, Eugene G.; Salaru, Gratian; Mohammed, Debbie; Coombs, Robert W.; Paul, Sindy M.; Cadoff, Evan M.

In: Journal of Clinical Virology, Vol. 58, No. SUPPL1, 12.2013.

Research output: Contribution to journalArticle

Martin, Eugene G. ; Salaru, Gratian ; Mohammed, Debbie ; Coombs, Robert W. ; Paul, Sindy M. ; Cadoff, Evan M. / Finding those at risk : Acute HIV infection in Newark, NJ. In: Journal of Clinical Virology. 2013 ; Vol. 58, No. SUPPL1.
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title = "Finding those at risk: Acute HIV infection in Newark, NJ",
abstract = "Background: A screening strategy combining rapid HIV-1/2 (HIV) antibody testing with pooled HIV-1 RNA testing increases identification of HIV infections, but may have other limitations that restrict its usefulness to all but the highest incidence populations. Objective: By combining rapid antibody detection and pooled nucleic acid amplification testing (NAAT) testing, we sought to improve detection of early HIV-1 infections in an urban Newark, NJ hospital setting. Study design: Pooled NAAT HIV-1 RNA testing was offered to emergency department patients and outpatients being screened for HIV antibodies by fingerstick-rapid HIV testing. For those negative by rapid HIV and agreeing to NAAT testing, pooled plasma samples were prepared and sent to the University of Washington where real-time reverse transcription-polymerase chain reaction (RT-PCR) amplification was performed. Results: Of 13,226 individuals screened, 6381 had rapid antibody testing alone, and 6845 agreed to add NAAT HIV screening. Rapid testing identified 115 antibody positive individuals. Pooled NAAT increased HIV-1 case detection by 7.0{\%} identifying 8 additional cases. Overall, acute HIV infection yield was 0.12{\%}. While males represent only 48.1{\%} of those tested by NAAT, all samples that screened positive for HIV-1 RNA were obtained from men. Conclusion: HIV-1 RNA testing of pooled, HIV antibody-negative specimens permits identification of recent infections. In Newark, pooled NAAT increased HIV-1 case detection and provided an opportunity to focus on treatment and prevention messages for those most at risk of transmitting infection. Although constrained by client willingness to participate in testing associated with a need to return to receive further results, use of pooled NAAT improved early infection sensitivity.",
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