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4th generation HIV screening in Massachusetts: a partnership between laboratory and program
Tammy Goodhue1, Arthur Kazianis2, Barbara G Werner3
1MDPH - Office of HIV/AIDS, 250 Washington Street, 3rd Floor, Boston, MA 02108, United States.
Summary
Massachusetts implemented a new HIV testing algorithm, successfully identifying acute HIV-1 infections and improving efficiency. This transition enhanced early diagnosis and linkage to care for individuals with HIV.
Area of Science:
- Public Health
- Infectious Disease Diagnostics
- Laboratory Medicine
Background:
- The Massachusetts Department of Public Health (MDPH) has provided HIV screening since 1985 through its Office of HIV/AIDS (OHA) and Hinton State Laboratory Institute (HSLI).
- Screening occurs at various sites across Massachusetts as part of an integrated communicable disease intervention.
Purpose of the Study:
- To transition to a 4th generation HIV screening algorithm for all serum specimens submitted to HSLI.
- Objectives included detecting acute HIV infections, differentiating HIV-1/HIV-2, reducing indeterminate results, cutting costs and turnaround times, and improving linkage to care.
Main Methods:
- A joint project management team from HSLI and OHA planned and executed the transition to the new algorithm.
- The laboratory implemented a revised diagnostic algorithm incorporating a 4th generation screening assay.
Main Results:
- Successful transition to a 4th generation HIV screening assay.
- In 12 months, 7984 specimens were tested: 258 (3.2%) HIV-1 positive, 1 HIV-2 positive, and 8 acute HIV-1 infections.
- Timely linkage to care and partner services for newly diagnosed individuals; reduced turnaround time and ~15% cost savings.
Conclusions:
- The use of sensitive screening tests is crucial for identifying acute HIV infections.
- A multidisciplinary team approach was vital for a successful transition.
- Lessons learned from this transition may benefit other public health jurisdictions.
