Tammy Goodhue1, Arthur Kazianis2, Barbara G Werner3, Tracy Stiles4, Barry P Callis5, H Dawn Fukuda6, Kevin Cranston7. 1. MDPH - Office of HIV/AIDS, 250 Washington Street, 3rd Floor, Boston, MA 02108, United States. Electronic address: Tammy.Goodhue@state.ma.us. 2. MDPH - Hinton State Laboratory Institute, 305 South Street, Jamaica Plain, MA 02130, United States. Electronic address: Arthur.Kazianis@state.ma.us. 3. MDPH - Bureau of Infectious Disease, 305 South Street, Jamaica Plain, MA 02130, United States. Electronic address: Barbara.Werner@state.ma.us. 4. MDPH - Hinton State Laboratory Institute, 305 South Street, Jamaica Plain, MA 02130, United States. Electronic address: Tracy.Stiles@state.ma.us. 5. MDPH - Office of HIV/AIDS, 250 Washington Street, 3rd Floor, Boston, MA 02108, United States. Electronic address: Barry.Callis@state.ma.us. 6. MDPH - Office of HIV/AIDS, 250 Washington Street, 3rd Floor, Boston, MA 02108, United States. Electronic address: Dawn.Fukuda@state.ma.us. 7. MDPH - Bureau of Infectious Disease, 305 South Street, Jamaica Plain, MA 02130, United States. Electronic address: Kevin.Cranston@state.ma.us.
Abstract
BACKGROUND: The Massachusetts Department of Public Health's (MDPH) Office of HIV/AIDS (OHA) and Hinton State Laboratory Institute (HSLI) have offered HIV screening since 1985. Point-of-care screening and serum collection for laboratory-based testing is conducted at clinic and non-clinic-based sites across Massachusetts as part of an integrated communicable disease screening intervention. OBJECTIVES AND PROJECT DESIGN: MDPH aimed to transition to a 4th generation HIV screening-based algorithm for testing all serum specimens collected at OHA-funded programs and submitted to the HSLI to detect acute HIV infections, detect and differentiate HIV-1 and HIV-2 infections, eliminate indeterminate results, reduce cost and turnaround time, and link newly diagnosed HIV+ individuals to care. The HSLI and OHA created a joint project management team to plan and lead the transition. RESULTS: The laboratory transitioned successfully to a 4th generation screening assay as part of a revised diagnostic algorithm. In the 12 months since implementation, a total of 7984 serum specimens were tested with 258 (3.2%) positive for HIV-1 and one positive for HIV-2. Eight were reported as acute HIV-1 infections. These individuals were linked to medical care and partner services in a timely manner. Turnaround time was reduced and the laboratory realized an overall cost savings of approximately 15%. CONCLUSIONS: The identification of eight acute HIV infections in the first year underscores the importance of using the most sensitive screening tests available. A multi-disciplinary program and laboratory team was critical to the success of the transition, and the lessons learned may be useful for other jurisdictions. Published by Elsevier B.V.
BACKGROUND: The Massachusetts Department of Public Health's (MDPH) Office of HIV/AIDS (OHA) and Hinton State Laboratory Institute (HSLI) have offered HIV screening since 1985. Point-of-care screening and serum collection for laboratory-based testing is conducted at clinic and non-clinic-based sites across Massachusetts as part of an integrated communicable disease screening intervention. OBJECTIVES AND PROJECT DESIGN: MDPH aimed to transition to a 4th generation HIV screening-based algorithm for testing all serum specimens collected at OHA-funded programs and submitted to the HSLI to detect acute HIV infections, detect and differentiate HIV-1 and HIV-2 infections, eliminate indeterminate results, reduce cost and turnaround time, and link newly diagnosed HIV+ individuals to care. The HSLI and OHA created a joint project management team to plan and lead the transition. RESULTS: The laboratory transitioned successfully to a 4th generation screening assay as part of a revised diagnostic algorithm. In the 12 months since implementation, a total of 7984 serum specimens were tested with 258 (3.2%) positive for HIV-1 and one positive for HIV-2. Eight were reported as acute HIV-1 infections. These individuals were linked to medical care and partner services in a timely manner. Turnaround time was reduced and the laboratory realized an overall cost savings of approximately 15%. CONCLUSIONS: The identification of eight acute HIV infections in the first year underscores the importance of using the most sensitive screening tests available. A multi-disciplinary program and laboratory team was critical to the success of the transition, and the lessons learned may be useful for other jurisdictions. Published by Elsevier B.V.
Entities:
Keywords:
4th generation HIV screening; Detecting acute HIV infection; HIV/AIDS; Laboratory and program partnership; Revised HIV testing algorithm
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