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Is there a need to repeat single assay reactive HIV screens? A review of practice in two UK sites
Callum Goolden1, Cheryl Williams2, Sabeen Khurshid Zaidi2
1Department of Virology, Manchester Medical Microbiology Partnership, United Kingdom; United Kingdom Health Security Agency, United Kingdom.
Background:
In the United Kingdom, a 3-step algorithm for HIV screening is standard practice. Where there is discordancy between different serological assays, the interpretation of HIV status is challenging and guidance on reporting and follow up is conflicting. Inconclusive HIV results often prompt requests for repeat testing which is known to cause considerable anxiety as well as increased healthcare costs.
Objectives:
We aimed to demonstrate the safety and efficacy of reporting single assay reactive HIV screens with a negative serum HIV-1 RNA PCR result as HIV negative, without the requirement for repeat sampling.
Study Design:
We conducted a retrospective review of local practice across two neighbouring NHS trusts. HIV results were reviewed to determine the proportion of single assay reactivity and to assess if any individuals exhibiting single assay reactivity were found to be HIV-1 positive by PCR, or with interval serological testing.
Results:
A total of 1225 (0.26 %) of HIV screening requests exhibited single assay reactivity. None of these were found to be HIV-1 positive by PCR. 356 individuals with single assay reactivity had repeat testing performed, but none were shown to have developed HIV infection.
Conclusions:
In our cohort, specimens exhibiting single HIV assay reactivity did not confirm when tested for HIV-1 RNA by PCR, or with interval serological testing of the source individual. This demonstrates the safety and efficacy of a longstanding approach at both NHS trusts.
