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Screening for Acute HIV-1 Infection at NYC DOHMH Public Health Laboratory William R. Oleszko, Ph.D. Associate Director, Public Health Laboratory Department.

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Presentation on theme: "Screening for Acute HIV-1 Infection at NYC DOHMH Public Health Laboratory William R. Oleszko, Ph.D. Associate Director, Public Health Laboratory Department."— Presentation transcript:

1 Screening for Acute HIV-1 Infection at NYC DOHMH Public Health Laboratory William R. Oleszko, Ph.D. Associate Director, Public Health Laboratory Department of Health and Mental Hygiene New York City

2 NYC PHL initiated use of new HIV antibody screening assay in April 2004: HIV-1/HIV-2 Plus “O” EIA by Bio-Rad Inc. Specimen Submission from April 2004 thru October 2007  226,150 specimens tested  213,593 (94.5%) NEGATIVE for antibodies to HIV-1/HIV-2  12,052 (5.3%) POSITIVE for antibodies to HIV-1  505 (0.2%) INCONCLUSIVE for antibodies to HIV-1 HIV ANTIBODY TESTING April 2004 – October 2007 April 2004 – October 2007

3 Public health testing strategy for hiv-1/HIV-2

4 ASSAYS PERFORMED ON SPECIMENS H HIV-1/HIV-2 Plus “O” EIA IV-1 Western Blot IV-1 EIA (rLAV) IV-2 EIA IV-1/HIV-2 Multispot Rapid EIA* (used for differentiation; currently, not for reporting purposes) C CD4/CD8 T-cell Enumeration* H HIV-1 DNA PCR* V Viral Load - HIV-1 RNA PCR & HIV-1 bDNA* H HIV-2 DNA PCR* IV-2 Western Blot (Send Out) * SPECIAL STUDY

5 CATEGORIES FOR SPECIAL STUDY Atypical HIV-1 Western blot banding pattern Atypical HIV-1 Western blot banding pattern Inconclusive: pregnant or two HIV-1 inconclusives within one month Inconclusive: pregnant or two HIV-1 inconclusives within one month HIV-2 reactivity HIV-2 reactivity Child of HIV positive mother Child of HIV positive mother HIV Positive, either on or not on HAART, undetectable viral load, declining CD4 HIV Positive, either on or not on HAART, undetectable viral load, declining CD4 Ora-Quick preliminary positive with Inconclusive/Negative confirmatory result Ora-Quick preliminary positive with Inconclusive/Negative confirmatory result Possible primary infection Possible primary infection  STD Clinic patients with flu-like symptoms  Outreach to high risk populations  Flu-like symptoms  Asymptomatic with recent high risk behavior

6 POSSIBLE ACUTE HIV INFECTION results HIV-1 Antibody RESULTS 206 Acute Infections 9 POSITIVE 24 1 NEGATIVE 182 8 submitter # of submissions # of AHI NYU154 6 (3.9 %) STD Clinics 52 3 (5.8 %) TOTAL TOTAL206 9 (4.4 %) POSSIBLEAcute HIV Infection (AHI) by submitter POSSIBLE Acute HIV Infection (AHI) by submitter

7 Sara T. Beatrice, Ph.D., Assistant Commissioner Division of Virology and Immunology: Amado Punsalang, Jr., Ph.D. Robert Pirillo – Community Coordinator Mona El-Fishawy - HIV Screening Lab Mohammad Younis – HIV Supplemental Testing Lab Ed Lee. Ph.D. – HIV PCR Lab Orlin Trochev, MD, Ph.D. – HIV Genotyping/Resistance Lab Otto Del Cid, MPA – Special Project Coordinator Maria Paz Carlos, Ph.D. – Chief, Virology Erica De Bernardo, Ph. D. –Chief, Immunology Erica De Bernardo, Ph. D. – Chief, Immunology NYC DOHMH STD Control Susan Blank, MD NYU Testing Project Robert Hagerty, Senior Research Coordinator Public Health Laboratory

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