HIV testing technologies after two decades of evolution.

Area of Science:

• Medical diagnostics
• Infectious disease monitoring
• Public health

Background:

• Human immunodeficiency virus (HIV) diagnostics have been crucial for global health over the last 20 years.
• Technological progress has led to improved screening, confirmatory, and monitoring assays for HIV.
• These advancements are vital for blood screening, surveillance, diagnosis, and patient management.

Purpose of the Study:

• To review the evolution and impact of HIV diagnostic technologies.
• To highlight the role of molecular methods in early detection and monitoring treatment resistance.
• To discuss the development of new assays for incidence estimation and intervention programs.

Main Methods:

• Review of technological advancements in HIV diagnostic assays.
• Focus on molecular methods for early infection detection and resistance monitoring.
• Examination of sensitive/less sensitive (detuned) assays for incidence estimation.
• Evaluation of newer rapid HIV kits and manual CD4 lymphocyte count assays.
• Assessment of simplified viral load estimation assays.

Main Results:

• Molecular methods are critical for early HIV detection and managing antiretroviral therapy resistance.
• Detuned assays provide valuable epidemiologic incidence estimates for intervention programs.
• Newer rapid HIV kits are temperature-stable, use simple sample types (fingerstick blood, oral fluids), and have user-friendly procedures.
• Manual CD4 lymphocyte count and simplified viral load assays are suitable for resource-limited settings.
• Technological progress yields more simplified, cost-effective, and accurate HIV testing globally.

Conclusions:

• Ongoing technological innovations in HIV diagnostics are essential for global health.
• These advancements address challenges in resource-limited settings, improving accessibility and accuracy.
• The evolution of HIV diagnostics supports better patient management and public health surveillance worldwide.