Testing for acute HIV infection: implications for treatment as prevention.

Abstract

The aim of this study is to give an overview of the recent literature related to HIV testing with an emphasis on detecting acute HIV infection. Testing technology as well as implications for treatment as prevention will be discussed. HIV testing technology continues to evolve. Advances include updated immunologic formats that detect both HIV antibody and antigen (4th generation assays), new nucleic acid amplification tests, and continued development of rapid assays that can be used in either clinical or nonclinical settings. Because of these advances there are proposed changes for HIV diagnostic algorithms to encourage detection of acute infection. These technologic advances have implications for HIV prevention as testing is a cornerstone for all HIV prevention strategies. There is considerable new research indicating that treatment may be an important aspect of HIV prevention. Data also suggest that detection of acute infection will be important for the success of these prevention strategies. Continued improvements in technology and testing practice are vital for the success of HIV prevention. Detection of acute or early HIV infection will likely play a key role in the success of treatment as prevention, as well as play an important role in ongoing behavioral prevention strategies.