2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Slide50of58FromHScott,MD,MPHatNewOrleans,LA,December4-7, 2019,RyanWhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

How to manage ambiguous HIV Test Results

Quarterly PrEP Screening

Ambiguous orDiscrepantHIV Tests 1. Confirm the presence or absence of infection

- Repeat serologic or RNA tests (DNA tests not validated) - Use a test from another manufacture

2. Manage antiretroviral drugs

Start ART if not adherent to PrEP

Stop PrEP reassess HIV Status

Continue PrEP if adherent

Facilitate Diagnosis Risk of Infection

Drug Related AEs Confirm Diagnosis

Maintains Protection Risk of Resistance

SmithetalOFID 2018;Stekler JDetalOFID2018;Saag Metal JAMA 2018

Slide51of58FromHScott,MD,MPHatNewOrleans,LA,December4-7, 2019,RyanWhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

How to manage ambiguous HIV Test Results

Quarterly PrEP Screening

Ambiguous orDiscrepantHIV Tests 1. Confirm the presence or absence of infection More experienceneeded to manage ambiguous test results For false-positiveresults: Repeat HIV testing, discuss with clinicians and virologists. Seek expert opinion and potentially additional research testing (ultrasensitive HIV VL testing). - Repeat serologic or RNA tests (DNA tests not validated) - Use a test from another manufacture

2. Manage antiretroviral drugs

PrEPline: 855-448-7737 (11am- 6pm PST)

Start ART if not adherent to PrEP

Stop PrEP reassess HIV Status

Continue PrEP if adherent

Facilitate Diagnosis Risk of Infection

Drug Related AEs Confirm Diagnosis

Maintains Protection Risk of Resistance

SmithetalOFID 2018;Stekler JDetalOFID2018;Saag Metal JAMA 2018

Slide52of58FromHScott,MD,MPHatNewOrleans,LA,December4-7, 2019,RyanWhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.