What is rapid HIV testing?

Updated: Sep 19, 2018
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Rapid human immunodeficiency virus (HIV) testing is intended for use when immediate information is required for the initiation of prophylaxis, as in occupational or nonoccupational exposure and in pregnant women in labor who have not undergone prior HIV testing. Rapid HIV testing is also useful when the patient is unlikely to return for a follow-up visit.

The rapid tests are based on the detection of antibodies in whole blood, plasma, serum, or oral fluid. Nine rapid tests are currently FDA approved for clinical settings and seven for non-clinical settings [36, 37, 38, 39] ; some of them detect both HIV-1 and HIV-2. The Clinical Laboratory Improvement Amendments (CLIA) regulates their performance. The tests are categorized as either CLIA “waived” or “moderate complexity.” The “waived” tests can be performed in settings such as emergency departments, mobile vans, and physician’s offices, as there are no federal restrictions/regulations. On the other hand, the “moderate complexity” tests must comply with all regulations and restrictions imposed by the CLIA.

The result of the test can be negative, which should be interpreted as a definite negative unless the testing occurred within the window period. A positive test result is considered preliminary and should be confirmed with Western blot or IFA. In resource-limited countries, an initial positive test result can be followed by another rapid test from another manufacturer. There are several algorithms available if rapid tests are used in this situation. [40]

For more information, see Rapid HIV Tests.

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