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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

Journal article
Authors Hans Gaines
Jan Albert
Maria Axelsson
Torsten Berglund
Magnus Gisslén
Anders Sönnerborg
Anders Blaxhult
Gordana Bogdanovic
Maria Brytting
Christina Carlander
Leo Flamholc
Per Follin
Axana Haggar
Per Hagstam
Marcus Johansson
Lars Navér
Jenny Persson Blom
Agneta Samuelson
Helena Ström
Veronica Svedhem Johansson
Martin Sundqvist
Karin Tegmark Wisell
Anders Tegnell
Rigmor Thorstensson
Published in Infectious diseases (London, England)
Volume 48
Issue 2
Pages 93-8
ISSN 2374-4243
Publication year 2016
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 93-8
Language en
Links dx.doi.org/10.3109/23744235.2015.10...
Subject categories Infectious Medicine

Abstract

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.

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