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

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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 of Health and
Mental Hygiene New York City
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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

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

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• 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

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POSSIBLE Acute HIV Infection (AHI) by submitter
submitter of submissions of AHI
NYU 154 6 (3.9 )
STD Clinics 52 3 (5.8 )
TOTAL 206 9 (4.4 )
POSSIBLE ACUTE HIV INFECTION results POSSIBLE ACUTE HIV INFECTION results
HIV-1 Antibody RESULTS 206 Acute Infections 9
POSITIVE 24 1
NEGATIVE 182 8
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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