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Avatar universal

New CDC testing rule?

Has any one seen this? About 4th gen test been negative then a second test is no longer required at 3 months

http://mobile.theverge.com/2014/6/27/5849588/cdc-recommends-testing-procedure-that-can-detect-hiv-four-weeks

Its by de CDC
31 Responses
366749 tn?1544695265
COMMUNITY LEADER
No ! This is not the official web site of CDC. Officially recommended guidelines remains at 3 months mark
707563 tn?1587576687
Hi everyone -

The CDC has indeed updated testing guidelines, and guidelines for PEP, treatment for HIV, and a few other things -

http://www.cdc.gov/hiv/pdf/HIVtestingAlgorithmRecommendation-Final.pdf

http://www.cdc.gov/hiv/guidelines/index.html

http://www.cdc.gov/hiv/testing/lab/guidelines/index.html

Em

Avatar universal
Thankyou for the links!

480448 tn?1426948538
Thanks for the info.

It's great that they're continuing to update their recommendations along with the advances in testing, I just wish they would find a more succinct way to put the info out there.  The pdf document is 68 pages long and is hard enough to wade through when you have a medical background.  That info is going to be useless for the lay person.

Hopefully they will update their site with their new recommendations in an obvious place, in clear language.  As of now, the testing guidelines on their site are the same as they have been, not anything new.

Thanks for sharing!!
480448 tn?1426948538
This chart is a little more "reader' friendly:

http://www.cdc.gov/nchhstp/newsroom/docs/2014/HIV-testing-Labs-Flowchart.pdf

Basically, the new recommendations suggest a DUO (4th gen) test, and if negative, they don't recommend any follow up testing.  If positive, the next step is NOT confirmation with the western blot as before, but rather a HIV-1/HIV-2 antibody differentiation immunoassay.  If positive, diagnosis is made of HIV-1 or HIV-2, if negative or indeterminate, a NAT test is then recommended.

I'm really very glad to see this, as the old recommendations were out of date with the 4th gen tests in the picture.  
Avatar universal
If the p24 component is not for hiv-2, wouldn't that mean that to fully exclude infection retesting at 12 weeks still applies?
I understand that it is a rare strain however.

Wow this is excellent news.

Also, thankyou for the reader friendly link nursegirl
480448 tn?1426948538
I'm not sure.

Obviously, the testing guidelines as they relate to antibody tests haven't changed.  This only changes the recommendations when the 4th gen tests are being used.
Avatar universal
So it would seem a negative duo test at 4 or more weeks is considered reliable, and a follow up test at 12 weeks to exclude both types of virus, keeping in mind that hiv-2 is rare.

I wonder if the doctors from the expert forums attended a meeting to help formulate the CCDs new guidelines.
Avatar universal
Glad to see i am not a spammer  :) thank you guys
Avatar universal
Exception: As of April 2014, data are insufficient to recommend use of the FDA-approved single-use rapid HIV-1/HIV-2 antigen/antibody combination immunoassay as the initial assay in the algorithm.
480448 tn?1426948538
It looks like they excluded the rapid tests, and the HIV-2 NAT tests (due to them lacking FDA approval).  I'm pleased to see that they included ONLY approved tests in their algorithim.  That will cut down on confusion between entities (ie CDC and testing manufacturers)
Avatar universal
That seems to contradict the info given on the user friendly chart.
Avatar universal
Number 1. on the chart.

1. Laboratories should conduct initial testing for HIV with an FDA-approved antigen/antibody combination immunoassay* that detects HIV-1 and HIV-2 antibodies and HIV-1 p24 antigen to screen for established infection with HIV-1 or HIV-2 and for acute HIV-1 infection

* Exception: As of April 2014, data are insufficient to recommend use of the FDA-approved single-use rapid HIV-1/HIV-2 antigen/antibody combination immunoassay as the initial assay in the algorithm.


None of the sites that say when one should test have been updated.
Avatar universal
Yeah I noticed that too regarding when one should test.

480448 tn?1426948538
Which sites, Teak?
480448 tn?1426948538
And, as for the exception, I'm pretty sure they're talking about the rapid test being excluded.  In order to be within their guidelines, one would have to use a standard lab drawn test I imagine.

This is all very new information, officially, and I'm glad to see it, so there's more consistency between what the expert docs are recommending, and the official guidelines.

I'm sure it will take some time before a lot of associated sites are updated.  I've seen links to the new guidelines, but the old verbiage is still there, which definitely can be confusing, especially for people who aren't at ALL familiar with HIV testing in any capacity.
Avatar universal
Is this saying that a rapid finger prick blood test with 20 minutes results are no longer seen as accurate ?
480448 tn?1426948538
No, it's saying that a rapid test would not be the test of choice in the algorithim as the first step in the new testing recommendations.

Rapid tests are still accurate, and when taken out to 3 months post exposure, are definitive.
Avatar universal
This is driving me crazy, mainly due to burning tingling in penile along with burning sore throat for 5 weeks now and stinging rectum with red blood today after wiping.

My HIV tests (can I move on) unprotected sex with female 9 weeks ago, not CSW or drug user. (all negative)

11 days - 4th gen
5.3 weeks - 4th gen
7.3 weeks - 3rd gen
8 weeks - 4th gen combo (20min) & 3rd gen rapid (1min)
Avatar universal
Non of those are related to ARS or HIV.
Avatar universal
Thank you Teak, I know your knowledge is excellent, so hearing this from you does help a lot. Thank you for the good work you do. 2.4 days till 12 weeks then I can put this behind me.
Avatar universal
what are the new guidelines for nPep?
Avatar universal
Don't hijack other people's threads.
Avatar universal
in chart its not written that 4 weeks is definative for fourth gen but it can detect 4 week earlier..so if guidelines before were 3 months ..so now with 4th gen its 2 months???I am confused
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