Official websites use. Share sensitive information only on official, secure websites. Address correspondence to John N. Nkengasong, nkengasongj africa-union. Diagnosis of human immunodeficiency virus infection. Clin Microbiol Rev e All Rights Reserved. HIV diagnostics have played a central role in the remarkable progress in identifying, staging, initiating, and monitoring infected individuals on life-saving antiretroviral therapy.
HIV diagnostics are critical in achieving epidemic control and require a hybrid of conventional laboratory-based diagnostic tests and new technologies, including point-of-care POC testing, to expand coverage, increase access, and positively impact patient management.
In this review, we provide i a historical perspective on the evolution of HIV diagnostics serologic and molecular and their interplay with WHO normative guidelines, ii a description of the role of conventional and POC testing within the tiered laboratory diagnostic network, iii information on the evaluations and selection of appropriate diagnostics, iv a description of the quality management systems needed to ensure reliability of testing, and v strategies to increase access while reducing the time to return results to patients.
Maintaining the central role of HIV diagnostics in programs requires periodic monitoring and optimization with quality assurance in order to inform adjustments or alignment to achieve epidemic control. There are challenges in reaching these targets for developing countries, which include government policies, financial provision, data-driven programming, operational coordination among health care agencies and implementing partners, and laboratory infrastructure 11 , However, recent U.
Currently, serologic testing algorithms using mostly rapid tests is used in resource-limited settings RLS to diagnose HIV infections. Serology-based incidence assays are widely used for estimating the rate of new infections in cross-sectional surveys, combined with viral load VL measurement in an algorithm.
