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Inpatient HIV Testing Procedures

The following is the new HIV testing procedure of HMC inpatients.  The procedures stated for “Sunday through Thursday” apply to ALL HIV testing (rapid and routine).  The procedures stated for Rapid Testing on Friday and Saturday apply only to those situations:

HIV testing for HMC inpatients: Turn-around time will be one working day

Sunday-Thursday: Order the routine HIV-1 & 2 Antibody test:

• Standard HIV-1 & 2 EIA will be performed Reactive EIA ---> Multispot rapid test (MSRT) on blood will be performed.
  
  
  • Reactive MSRT: will be reported as "presumptive HIV+". This result must be confirmed by WB later in the week.
  • Non-Reactive MSRT: will be reported as "inconclusive". This result is different than an "indeterminate" Western Blot. We do not currently have data to know the relative proportion of these results that are likely to be true or false positive EIA test results. All "Reactive EIA, non-reactive MSRT" results must be resolved by Western Blot later in the week.
• Non-Reactive EIA---> reported as "negative, not HIV infected"

Friday and Saturday: If you need a result in one working day - Order “HIV Rapid test” (must call the lab medicine resident for permission):

• Rapid Oraquick test on blood will be performed
• Reactive Oraquick: will be reported as "presumptive HIV+" (must be confirmed by standard EIA and Western Blot later in the week)
• Non-Reactive Oraquick: will be reported as "presumptive HIV-, not HIV infected" (must be confirmed by negative standard EIA later)
• Note that all these HIV antibody tests will be negative in the first weeks following HIV infection, and that cases of sero-reversion (from positive to false negative) have been documented in late-stage HIV infection. Patients with a very high likelihood of HIV infection should have repeated HIV antibody testing and possibly HIV RNA testing before HIV infection is excluded.