What are the CDC recommendations for HIV testing?

Updated: Jul 27, 2020
  • Author: Shelley A Gilroy, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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In June 2014, the Centers for Disease Control and Prevention (CDC) issued new recommendations for HIV testing in laboratories that are aimed at reducing the time needed to diagnose HIV infection by as much as 3-4 weeks over previous testing approaches. The new testing algorithm is performed as follows [94, 95] :

  • Diagnosis starts with a fourth-generation test that detects HIV in the blood earlier than antibody tests can; it identifies the viral protein HIV-1 p24 antigen, which appears in the blood before antibodies do

  • If this test is positive, an immunoassay that differentiates HIV-1 from HIV-2 antibodies should be performed; results from such assays can be obtained faster than they can from the Western blot test

  • In patients with positive results on the initial antigen test but with negative or indeterminate results on the antibody differentiation assay, HIV-1 nucleic acid testing should be performed to determine whether infection is present

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