BACKGROUND: Prior to 2012, all confirmatory HIV Western Blot (WB) for Alaska patients were sent to out-of-state reference laboratories. In 2012, the Alaska State Virology Laboratory (ASVL) began using the BioRad Multispot HIV-1/HIV-2 antibody differentiation immunoassay for in-house confirmation of HIV. This project examined the timeliness of human immunodeficiency virus (HIV) test reporting and linkage to care with a new in-house serodiagnosis and confirmation algorithm adopted by the ASVL, and determined if transitioning to the new algorithm impacted the turnaround time of test reporting and linkage to care.
METHODS: Laboratory data from January 2010 through October 2015 were analyzed to determine the average number of days from the specimen collection date to the date of laboratory report, as well as the date of initial CD4 and viral load (VL), which are used as a proxy to determine if an HIV patient has been linked to medical care. The average number of days from the date of report to the date of initial CD4 and VL testing were also analyzed to determine if the Alaska Section of Epidemiology’s new Linkage to Care (L2C) Program, which was implemented during the same period, might have also affected the linkage to care turnaround time.
RESULTS: The laboratory data showed that transitioning from WB to Multispot reduced the average turnaround time from the collection date to the report date from 11.3 days [range 9–19] to 6.2 days [range 3–9], and reduced the time from the date of specimen collection to the date of the initial CD4 and VL tests from an average of 17.8 days [range 11–29] to 13.1 days [range 4–28]. The average number of days from the date of report to the date of initial CD4 and VL did not change, indicating that the L2C program efforts did not impact turnaround times.
CONCLUSIONS: Offering in-house confirmatory testing for HIV reduced the turnaround time of test reporting and linkage to care. This reduction can result in direct health benefits to the patient as well as benefits to the wider public through preventing further HIV transmission.