Laboratory diagnosis of HIV: a contemporary overview in the Australian context

Eloise Williams; Michael Moso; Chuan Lim; Doris Chibo; Suellen Nicholson; Kathy Jackson; Deborah Anne Williamson

doi:10.1016/j.pathol.2023.04.001

Laboratory diagnosis of HIV: a contemporary overview in the Australian context

Pathology. 2023 Aug;55(5):610-620. doi: 10.1016/j.pathol.2023.04.001. Epub 2023 May 23.

Authors

Eloise Williams¹, Michael Moso², Chuan Lim³, Doris Chibo³, Suellen Nicholson³, Kathy Jackson³, Deborah Anne Williamson⁴

Affiliations

¹ Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia. Electronic address: eloise.williams@mh.org.au.
² Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia.
³ Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia.
⁴ Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia.

PMID: 37302942
DOI: 10.1016/j.pathol.2023.04.001

Abstract

Over the past decade there have been technical advances in human immunodeficiency virus (HIV) assays and updates to testing regulations that have substantially changed the landscape of laboratory testing for HIV. In addition, there have been significant changes in the epidemiology of HIV in Australia in the context of highly effective contemporary biomedical treatment and prevention strategies. Here, we provide an update on contemporary issues for the laboratory detection and confirmation of HIV in Australia. These include (1) the impact of early treatment and biological prevention strategies on the serological and virological detection of HIV; (2) the updated national HIV laboratory case definition and its interaction with testing regulations, public health and clinical guidelines; and (3) novel strategies for the laboratory detection of HIV, including the incorporation of HIV nucleic acid amplification tests (NAATs) into testing algorithms. These developments present an opportunity to develop a nationally consistent contemporary HIV testing algorithm that would result in optimisation and standardisation of HIV testing in Australia.

Keywords: ART; HIV; PrEP; public health; serology; virology.

Publication types

Review

MeSH terms

Australia / epidemiology
Clinical Laboratory Techniques
HIV Infections* / diagnosis
HIV Infections* / drug therapy
HIV Infections* / epidemiology
HIV*
Humans
Nucleic Acid Amplification Techniques