XVIII International AIDS Conference

Abstract

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Toward “real time” HIV/STI diagnosis in the HIV/AIDS program of Mexico City (HIVPMC)

L. Juárez-Figueroa1, J. Arellano2, P. Iracheta1, A. González3

1HIV/AIDS Program of Mexico City, HIV Laboratory, Mexico City, Mexico, 2HIV/AIDS Program of Mexico City, Prevention, Mexico City, Mexico, 3HIV/AIDS Program of Mexico City, Program Coordinator, Mexico City, Mexico

Background: HIVPMC provides attention to uninsured population, offering also confirmation for PMTCT and othr City programs. HIVPMC gives rapid test VCT to MSM, SW and TTT. Until recently HIVPMC lacked of opportune HIV/STI complete diagnosis mainly due to slow and costly referral to a centralized system that delayed laboratory results feedback from several weeks to several months. This prevented opportune medical decisions, and provoked loss of adherence among VCT clients.
In order to speed up HIV/STI diagnosis, to reduce costs and in general to improve the quality of data output while procuring at the same time a suitable laboratory platform for HIV/STI population surveys, we instrumented an automated system already used across the world for blood donors screening and replaced traditional WB confirmation with a quicker strip test.
Methods: We implemented Abbott HIV 1&2 Ag/Ab Combo, Anti-HBc, Anti-HCV and Syphilis TP quimioluminiscence immunoassay running in Architect i2000. HIV+ samples are confirmed with HIV 1&2 CombFirm (Orgenics). Anti-HBc+ are tested with Determine HBsAg and Syphilis TP+ with tittered V.D.R.L. We test with the above all persons with an HIV+ rapid test result at VCT.
Results: During December 2009 and January 2010, 137/808 (16.9%) men and 8/452 (1.8%)women were positive with rapid test and all of them were confirmed. Lab results were delivered to doctors next day. Tables 1 and 2 show the rate of coinfections by sex.

HIV+HBc+HBc+ HBsAg+HVC+Anti-T.pallidum+Anti-T.pallidum+ V.D.R.L.+
137/808 (16.9%)46/137 (33.6%)8/137 (5.8%)4/137 (2.9%)37/137 (27.0%)20/137 14.6%
[Table 1.VCT, HIV/STI coinfections. Men]



HIV+HBc+HBc+ HBsAg+HVC+Anti-T.pallidum+Anti-T.pallidum+ V.D.R.L.+
8/452 (1.8%)1/8 (12.5%)0/80/82/8 (25%)1/8 (12.5%)
[Table 2. VCT, HIV/STI coinfections. Women]


Conclusions: Fast assesment of HIV/STI increases adherence and allows on time treatment of coinfections, This approach to “real time” HIV/STI diagnosis could be further improved with the adition of NAAT to all specimens negative with a rapid test.


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