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Updated: May 16, 2026
Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3
Published on: December 27, 2010
[Three-Year Multicenter Analysis of HIV Infection Diagnostic Data]
Aysel Karataş1, Mert Ahmet Kuşkucu2, Seyhan Ördekçi3
1Sağlık Bilimleri Üniversitesi Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, İstanbul.
Insights
Türkiye updated its HIV testing algorithm in 2019. The study found increased use of rapid HIV tests and decreased HIV nucleic acid amplification testing (NAT) due to COVID-19, requiring ongoing HIV epidemic monitoring.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Public Health
Background:
- Türkiye adopted the updated three-step human immunodeficiency virus (HIV) testing algorithm in 2019, aligning with CDC guidelines.
- The study addresses the need to understand the current landscape of HIV diagnosis in Türkiye.
Purpose of the Study:
- To evaluate the performance of the current HIV testing algorithm in Türkiye.
- To identify challenges and propose solutions for HIV diagnosis.
- To assess the impact of the updated algorithm and external factors like the COVID-19 pandemic on HIV testing practices.
Main Methods:
- A multicenter, multidisciplinary approach was used, surveying 12 HIV testing centers with a 57-question survey.
- Data from 2018-2020 included HIV enzyme-linked immunosorbent assay (ELISA) tests, reactive rates, confirmatory test results, and HIV nucleic acid amplification tests (NAT).
- Analysis focused on trends in Western Blot (WB) utilization versus HIV-1/2 antibody differential rapid tests and HIV-1 RNA testing.
Main Results:
- Between 2018-2020, anti-HIV ELISA tests showed stable confirmed HIV rates (0.21-0.25%) with a slight increase in repeat reactivity (0.48-0.70%).
- Western Blot (WB) utilization decreased significantly (25.77% to 9.86%), while HIV-1/2 antibody differential rapid tests increased (25.72% to 45.78%), indicating a shift in confirmatory methods.
- HIV-1 NAT utilization saw a significant decrease in 2020 (46.31%) compared to 2019 (97.98%), attributed to resource reallocation towards COVID-19 testing.
Conclusions:
- The rapid HIV-1/2 antibody differential test is increasingly effective in HIV diagnosis in Türkiye.
- The decline in HIV-1 NAT use, potentially linked to the COVID-19 pandemic, necessitates close monitoring of the HIV epidemic.
- Further investigation is needed to understand the long-term implications of these shifts in testing algorithms and resource allocation.
Abstract:
The three step human immunodeficiency virus (HIV) testing algorithm used in Türkiye was updated and implemented in 2019 in accordance with the current HIV testing algorithm of the Centers for Disease Control and Prevention. In this study, it was aimed to obtain HIV test data with a multicenter and multidisciplinary approach in order to reveal the current situation in the diagnosis of HIV/acquired immunodeficiency syndrome in our country and to identify new algorithm applications and problems encountered in HIV diagnosis. For this purpose, 12 HIV testing centers were asked about the HIV testing algorithms they use, the problems they encountered in practice and their suggestions for solution with a 57-question survey. The performance of the current algorithm and the current HIV status of the centers were evaluated with the total number of three-year fourth generation HIV enzyme linked immunsorbent assay (ELISA) tests , the number of repeated reactive tests, the distribution of confirmatory test results and the number of HIV nucleic acid amplification tests (NAT) between 2018 and 2020. Between 2018 and 2020, the total number of anti-HIV ELISA tests were 788261, 871299 and 835498, the repeating reactivity rates were 0.48, 0.51 and 0.70, respectively, while the confirmed HIV test rates were 0.24, 0.25 and 0.21 respectively. During this period the rates of Western Blot (WB) confirmatory test utilization were 25.77%, 12.29% and 9.86%, respectively and are gradually decreasing. The utilization rates of HIV-1/2 antibody differential rapid confirmatory tests recommended in the current algorithm were found to be 25.72%, 38.76% and 45.78%, respectively and it is seen to replace WB. The rates of HIV-1 RNA studied by year were 48.77%, 97.98% and 46.31% respectively. In our study, it has been observed that the use of the rapid HIV-1/2 antibody differential test, which is included in the new algorithm, is gradually increasing and is used more effectively in HIV diagnosis, while the use of HIV-1 NAT has decreased. This situation, which is associated with the shift of NAT opportunities to coronavirus diseases-2019 (COVID-19) polymerase chain reaction studies in the shadow of the COVID-19 pandemic, requires more detailed monitoring in terms of possible changes in the HIV epidemic in our country.
