Research Information System
26th Annual Conference of the European Society for Clinical Virology, Frankfurt, Germany, 18 - 21 September 2024, pp.267-268, (Summary Text)
AIM: This study aimed to evaluate the effectiveness of the current HIV diagnostic algorithm.
METHODS: In accordance with CDC algorithm, our laboratory uses Architect. HIVAg/Ab for screening, Geenius™
HIV1/2 and Artus. HIVirus-1 QS-RGQ for confirmation. The Geenius™ test was used as a reflex and the HIV-1-
RNA required clinician order.
RESULTS: HIVAg/Ab test was performed in 82,882 sera and found to be reactive in 262 (0.3%). HIV-antibody
confirmatory testing was performed on 79% of samples with reactive screening test, and the presence of HIV-1
antibodies was confirmed in 51% (105/206). Half of the samples with positive-screening but negative-antibody
confirmatory result were tested for HIV1-RNA and viremia was detected in 5, confirming acute HIV-1 infection. HIV1-
RNA was not ordered for 49 samples with positive-screening and negative antibody-confirmation test,16 of these
were considered as false-reactive by the clinician. The Geenius assay result was indeterminate in 1.45% (3/206) of the
samples. In the algorithm, the number of Geenius tests would have been reduced by 25% if HIV1-RNA had been applied
as a reflex test to HIV-Ag/Ab positive samples and Geenius testing had been performed on RNA negative samples
CONCLUSIONS: A retrospective analysis showed that the HIV diagnostic algorithm was not fully implemented. An
important factor was that clinicians did not order HIV1-RNA-PCR from ELISA reactive and Geenius test negative
patients. It is predicted that the use of HIV1-RNA-PCR as a reflex test in HIV-Ag/Ab positive samples will provide
earlier diagnosis and the use of fewer Geenius test will reduce uncertain results and diagnostic cost.
SOURCES OF FUNDING: none.