Six-week follow-up after HIV-1 exposure: a position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy
Review article, 2016
In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.
hiv follow-up window period
prophylaxis
hiv-2
hiv-1
Author
Hans Gaines
Karolinska Institutet
Public Health Agency of Sweden
Karolinska University Hospital
Jan Albert
Swedish Reference Group for Antiviral Therapy
Karolinska Institutet
Karolinska University Hospital
Maria Axelsson
Public Health Agency of Sweden
Torsten Berglund
Public Health Agency of Sweden
Magnus Gisslén
Swedish Reference Group for Antiviral Therapy
University of Gothenburg
A. Sonnerborg
Karolinska University Hospital
Swedish Reference Group for Antiviral Therapy
Karolinska Institutet
Anders Blaxhult
Västmanland Hospital
Gordana Bogdanovic
Karolinska University Hospital
Maria Brytting
Public Health Agency of Sweden
Christina Carlander
Västmanland Hospital
Swedish Reference Group for Antiviral Therapy
Leo Flamholc
Swedish Reference Group for Antiviral Therapy
Skåne University Hospital
Per Follin
Region Västra Götaland
Axana Haggar
National Board of Health and Welfare
Per Hagstam
Skåne University Hospital
Marcus Johansson
Kalmar Regional Hospital
Lars Navér
Karolinska University Hospital
Karolinska Institutet
Swedish Reference Group for Antiviral Therapy
Jenny Persson Blom
Swedish Work Environment Authority
Agneta Samuelson
Karolinska University Hospital
Helena Ström
National Board of Health and Welfare
Martina Sundqvist
Örebro University Hospital
Veronica Svedhem Johansson
Karolinska University Hospital
Karin Tegmark Wisell
Public Health Agency of Sweden
Anders Tegnell
Public Health Agency of Sweden
Rigmor Thorstensson
Public Health Agency of Sweden
Infectious Diseases
2374-4235 (ISSN) 2374-4243 (eISSN)
Vol. 48 2 93-98Subject Categories
Infectious Medicine
DOI
10.3109/23744235.2015.1089593
PubMed
26414596