CDC to encourage use of rapid tests for HIV

Source patient window period to be addressed

The Centers for Disease Control and Prevention is expected to encourage rapid HIV tests more strongly in new guidance for HIV post-exposure prophylaxis (PEP) of health care workers that will be issued in the coming months, Hospital Infection Control has learned. Proponents of the tests have argued that rapid diagnosis can spare health care workers "the agony after the injury" as they await word on their HIV status.

"We will encourage the use of rapid testing because you can do it very fast, and you don’t have to expose the worker to drugs that are not necessary and that cause side effects," said Denise Cardo, MD, chief of the HIV infections branch in the CDC’s hospital infections program.

The new guidelines, which are expected to be published in the CDC’s Morbidity and Mortality Weekly Report around the end of the year, will combine the agency’s PEP recommendations for occupational exposures to HIV, hepatitis B, and hepatitis C into one document.

In addition to rapid testing, the CDC will update information on new antiviral drugs and combination therapies for HIV. New PEP protocols for exposures to resistant strains of HIV also will be included, as well as advice not to initiate PEP based solely on concerns about the patient window period prior to seroconversion, she said.

"People are very concerned about the window period of the source patient," explained Cardo. "So sometimes, [even] if the patient is negative, they say, What if this patient is in the window period?’ It is very clear — especially with the new tests available for HIV — if it is negative, the likelihood of that person being negative and not being in the window period is very, very high."