Point of Care Tests for HIV

Point-of-care tests for HIV play a substantial role in identifying new HIV infections and facilitating linkage to care.  However, with increasing recognition of the importance of acute HIV infection in the onward transmission of HIV, the need for accurate diagnosis during early infection might offset some of the benefits associated with point-of-care testing, such as improved access for hard to reach populations and reduced turnaround time for test results.   CDC has proposed a new diagnostic HIV testing algorithm designed to improve detection of acute HIV infection, reduce indeterminate test results, and facilitate the correct classification of HIV-2 infections.  However, this new diagnostic algorithm currently depends on conventional laboratory assays. This presentation will describe existing and emerging technologies for HIV tests and review the available evidence for differences in the sensitivity of FDA-approved point of care and laboratory assays during early infection, and also with different specimen types. The presentation will also assess recent data on the performance of algorithms based on combinations of point-of-care tests in international settings, and the implications for interpretation of test results and quality assurance.  The presentation will end with a description of HIV diagnostic technologies on the horizon, including tests designed for confirmation at the point-of-care and rapid, near-patient HIV nucleic acid tests.