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Screening for Acute HIV-1 Infection at NYC DOHMH Public Health Laboratory

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. HIV ANTIBODY TESTING April 2004 – October 2007.

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Screening for Acute HIV-1 Infection at NYC DOHMH Public Health Laboratory

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  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. HIV ANTIBODY TESTING April 2004 – October 2007 • 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

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

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

  5. CATEGORIES FOR SPECIAL STUDY • Atypical HIV-1 Western blot banding pattern • Inconclusive: pregnant or two HIV-1 inconclusives within one month • HIV-2 reactivity • Child of HIV positive mother • HIV Positive, either on or not on HAART, undetectable viral load, declining CD4 • Ora-Quick preliminary positive with Inconclusive/Negative confirmatory result • 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. POSSIBLEAcute HIV Infection (AHI) by submitter

  7. Public Health Laboratory • 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 • NYC DOHMH STD Control • Susan Blank, MD • NYU Testing Project • Robert Hagerty, Senior Research Coordinator

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