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HIV testing can help prevent disease transmission and improve patient outcomes

Approximately 1.2 million people in the US are infected with HIV.1 Testing is crucial for diagnosing, treating, and preventing HIV to improve health outcomes and bring an end to the HIV epidemic. Quest can support you with the tests you need at every stop along the HIV care continuum. And, with more than 2,000 Patient Service Centers around the country plus broad health plan coverage, Quest is easily accessible for your patients.

It all starts with screening

Nearly 160,000 people in the US are unaware that they have HIV and transmit nearly 40% of new HIV infections.1 The Centers for Disease Control (CDC) recommends screening all patients age 13-64 for HIV at least once, regardless of their risk level, using an opt-out approach. Individuals who may be at an increased risk should be screened at least annually.Identifying HIV early links patients to the appropriate treatment and care pathway sooner.

4th-generation HIV testing

The CDC recommends an HIV diagnostic testing algorithm based on 4th-generation antigen/antibody (Ag/Ab) combination assays.3,4 Our HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes assay is consistent with the current algorithm, which has been supported by Quest Diagnostics and CDC collaboration in key clinical studies.5-8


Caring for patients with HIV

Achieve and maintain an undetectable viral load and prevent further transmission.9 Quest's comprehensive test offerings for ongoing HIV management can help you do the following.

The CD4+ T-cell (CD4) count is the most valuable indicator of immune status and the strongest predictor of disease progression and survival in patients with HIV infection.11 Once a patient is diagnosed with HIV, baseline CD4 counts should be measured and then monitored every 3-6 months in patients who do not immediately begin ART.11

HIV-1 viral load is the primary marker of ART effectiveness. Before treatment begins, the viral load provides information on the risk of disease progression, helps informs treatment selection, and establishes a baseline for assessing treatment response.11 After treatment has begun, measuring viral load helps assess therapy efficacy.

Lab testing is an important tool for selecting drug regimens when initiating ART or changing regimens due to inefficacy. Such tests include genotypic HIV resistance to identify drug resistance-associated mutations, HIV-1 coreceptor tropism testing to help determine eligibility for treatment with CCR5 antagonists, and HLA-B*5701 typing for genetic risk stratification prior to initiation of Abacavir therapy.

The CDC recommends that all individuals infected with HIV be tested for hepatitis B virus (HBV) and hepatitis C virus (HCV). Approximately 2% of people with HIV in the US also have HBV, and HCV coinfection occurs in nearly 75% of people with HIV who also inject drugs. People with HIV are at greater risk for complications and death from HBV and/or HCV infection.12

Additionally, the CDC recommends that all sexually active persons with HIV be screened for syphilis, gonorrhea, and chlamydia first at the initial care visit and then on an annual basis. Women should also be screened for trichomoniasis at these same intervals. Those at an increased risk for STIs should be screened more frequently based on their individual risk.13


The power of prevention

Pre-exposure prophylactic (PrEP) medications could benefit an estimated 1.2M people in the US, but fewer than 36% of them are taking such prescriptions.14 PrEP could help reduce the risk of getting HIV in the following ways.

Coming soon from Quest: Flexible and accessible PrEP testing

Subscribe to communications from Quest to be notified of new PrEP offerings later in 2024

Opt in now
  • CDC guideline-recommended tests to determine clinical eligibility and to monitor patients while on PrEP
  • Flexible testing options so you can choose the right test based on your patient's unique requirements
  • Billing and reimbursement challenges mitigated by our updated menu offerings
  • Gender-inclusive testing language designed to cater to all your patients, regardless of gender

 

References 

 

  1. CDC. HIV Testing. Updated June 9, 2022. Accessed April 23, 2024. https://www.cdc.gov/hiv/testing/index.html
  2. CDC. How do I screen for HIV? Updated June 1, 2023. Accessed August 22, 2023. https://www.cdc.gov/hiv/clinicians/screening/how.html
  3. Branson BM, Owen SM, Wesolowski LG, et al. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Centers for Disease Control and Prevention. Published June 27, 2014. Accessed February 22, 2022. doi:10.15620/cdc.23447
  4. National Center for HIV/AIDS, Viral Hepatitis, and TB Prevention (US) Division of HIV/AIDS Prevention, Association of Public Health Laboratories. 2018 quick reference guide: recommended laboratory HIV testing algorithm for serum or plasma specimens. Centers for Disease Control and Prevention. Updated January 2018. Accessed February 22, 2022. https://stacks.cdc.gov/view/cdc/50872
  5. Delaney KP, Heffelfinger JD, Wesolowski LG, et al. Performance of an alternative laboratory-based algorithm for HIV diagnosis in a high-risk population. J Clin Virol. 2011;52(suppl 1):S5-S10. doi:10.1016/j.jcv.2011.09.013
  6. Nasrullah M, Wesolowski LG, Meyer WA III, et al. Performance of a fourth-generation HIV screening assay and an alternative HIV diagnostic testing algorithm. AIDS. 2013;27(5):731-737. doi:10.1097/QAD.0b013e32835bc535
  7. Wesolowski LG, Delaney KP, Hart C, et al. Performance of an alternative laboratory-based algorithm for diagnosis of HIV infection utilizing a third generation immunoassay, a rapid HIV-1/HIV-2 differentiation test and a DNA or RNA-based nucleic acid amplification test in persons with established HIV-1 infection and blood donors. J Clin Virol. 2011;52(suppl 1):S45-S49. doi:10.1016/j.jcv.2011.09.026
  8. Wesolowski LG, Delaney KP, Meyer WA III, et al. Use of rapid HIV assays as supplemental tests in specimens with repeatedly reactive screening immunoassay results not confirmed by HIV-1 Western blot. J Clin Virol. 2013;58(1):240-244. doi:10.1016/j.jcv.2013.06.019
  9. CDC. HIV treatment and care. Updated March 6, 2023. Accessed July 26, 2023. https://www.cdc.gov/hiv/clinicians/treatment-care/index.html
  10. Thompson MA, Horberg MA, Agwu AL, et al. Primary care guidance for persons with human immunodeficiency virus: 2020 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2021;73(11):e3572-e3605. doi:10.1093/cid/ciaa1391
  11. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated September 21, 2022. Accessed November 9, 2022. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf 
  12. Office of Infectious Disease and HIV/AIDS Policy, HHS. HIV.gov. Hepatitis B & C. Updated January 22, 2024. Accessed April 23, 2024. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/hepatitis-b-and-c
  13. CDC. HIV - STI Treatment Guidelines. Updated July 22, 2021. Accessed May 22, 2024. https://www.cdc.gov/std/treatment-guidelines/hiv.htm
  14. Office of Infectious Disease and HIV/AIDS Policy, HHS. Ready, Set, PrEP. HIV.gov. Updated March 18, 2022. Accessed October 5, 2023. https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/prep-program/
  15. CDC. Pre-Exposure Prophylaxis (PrEP). Updated July 5, 2022. Accessed October 5, 2023. https://www.cdc.gov/hiv/risk/prep/index.html