Challenges of HIV diagnosis and management in the context of pre‐exposure prophylaxis (PrEP), post‐exposure prophylaxis (PEP), test and start and acute HIV infection: a scoping review
Introduction Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV‐status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of...
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| Vydáno v: | Journal of the International AIDS Society Ročník 22; číslo 12; s. e25419 - n/a |
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| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Switzerland
International AIDS Society
01.12.2019
John Wiley & Sons, Inc John Wiley and Sons Inc |
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| ISSN: | 1758-2652, 1758-2652 |
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| Abstract | Introduction
Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV‐status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV‐specific antibody point‐of‐care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre‐exposure prophylaxis (PrEP) or post‐exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false‐negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection.
Discussion
Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV‐specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource‐limited, high HIV burden settings where HIV‐antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource‐wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified.
Conclusions
With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. |
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| AbstractList | Introduction: Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV-status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV-specific antibody point-of-care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false-negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection. Discussion: Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV-specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource-limited, high HIV burden settings where HIV-antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viralload, complicating current HIV testing algorithms in resource-wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified. Conclusions: With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. Keywords: Acute HIV infection; pre-exposure prophylaxis; post-exposure prophylaxis; immediate antiretroviral therapy; HIV testing algorithms; indeterminate HIV test Introduction Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV‐status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV‐specific antibody point‐of‐care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre‐exposure prophylaxis (PrEP) or post‐exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false‐negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection. Discussion Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV‐specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource‐limited, high HIV burden settings where HIV‐antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource‐wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified. Conclusions With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. IntroductionKnowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV‐status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV‐specific antibody point‐of‐care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre‐exposure prophylaxis (PrEP) or post‐exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false‐negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection.DiscussionMissed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV‐specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource‐limited, high HIV burden settings where HIV‐antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource‐wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified.ConclusionsWith increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV-status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV-specific antibody point-of-care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false-negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection.INTRODUCTIONKnowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV-status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV-specific antibody point-of-care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false-negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection.Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV-specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource-limited, high HIV burden settings where HIV-antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource-wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified.DISCUSSIONMissed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV-specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource-limited, high HIV burden settings where HIV-antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource-wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified.With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable.CONCLUSIONSWith increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. Introduction: Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV?status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV?specific antibody point?of?care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre?exposure prophylaxis (PrEP) or post?exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false?negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection. Discussion: Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV?specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource?limited, high HIV burden settings where HIV?antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource?wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified. Conclusions: With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV-status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV-specific antibody point-of-care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false-negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection. Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV-specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource-limited, high HIV burden settings where HIV-antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource-wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified. With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable. |
| Audience | Academic |
| Author | Sanders, Eduard J Doherty, Meg Brown, Colin Patel, Pragna Elliott, Tamara Cairns, Gus Ananworanich, Jintanat Fidler, Sarah Ndung'u, Thumbi Cohen, Myron Rutstein, Sarah E |
| AuthorAffiliation | 9 Max Planck Institute for Infection Biology Berlin Germany 15 Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA 5 Department of HIV and Global Hepatitis Programme WHO Geneva Switzerland 10 Department of Internal Medicine Division of Infectious Diseases UNC School of Medicine University of North Carolina At Chapel Hill Chapel Hill NC USA 12 NAM Aidsmap London United Kingdom 11 Division of Global HIV and TB Centers for Disease Control and Prevention Atlanta GA USA 8 The Ragon Institute of Massachusetts General Hospital Massachusetts Institute of Technology and Harvard University Cambridge MA USA 1 Imperial College London London United Kingdom 13 PrEP in Europe Initiative London United Kingdom 2 Imperial College Healthcare NHS Trust London United Kingdom 3 Kenya Medical Research Institute‐Wellcome Trust Research Programme Kilifi Kenya 4 Nuffield Department of Medicine University of Oxford Oxford United Kingdom 17 Department of Infection Royal Free London NHS Founda |
| AuthorAffiliation_xml | – name: 4 Nuffield Department of Medicine University of Oxford Oxford United Kingdom – name: 1 Imperial College London London United Kingdom – name: 13 PrEP in Europe Initiative London United Kingdom – name: 11 Division of Global HIV and TB Centers for Disease Control and Prevention Atlanta GA USA – name: 16 National Infection Service, Public Health England London United Kingdom – name: 3 Kenya Medical Research Institute‐Wellcome Trust Research Programme Kilifi Kenya – name: 15 Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA – name: 6 Africa Health Research Institute Durban South Africa – name: 2 Imperial College Healthcare NHS Trust London United Kingdom – name: 7 HIV Pathogenesis Programme Doris Duke Medical Research Institute University of KwaZulu‐Natal Durban South Africa – name: 10 Department of Internal Medicine Division of Infectious Diseases UNC School of Medicine University of North Carolina At Chapel Hill Chapel Hill NC USA – name: 17 Department of Infection Royal Free London NHS Foundation Trust London United Kingdom – name: 9 Max Planck Institute for Infection Biology Berlin Germany – name: 14 U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA – name: 8 The Ragon Institute of Massachusetts General Hospital Massachusetts Institute of Technology and Harvard University Cambridge MA USA – name: 12 NAM Aidsmap London United Kingdom – name: 5 Department of HIV and Global Hepatitis Programme WHO Geneva Switzerland – name: 18 Imperial College NIHR BRC London United Kingdom |
| Author_xml | – sequence: 1 givenname: Tamara orcidid: 0000-0001-8232-9413 surname: Elliott fullname: Elliott, Tamara organization: Imperial College Healthcare NHS Trust – sequence: 2 givenname: Eduard J surname: Sanders fullname: Sanders, Eduard J organization: University of Oxford – sequence: 3 givenname: Meg surname: Doherty fullname: Doherty, Meg organization: WHO – sequence: 4 givenname: Thumbi surname: Ndung'u fullname: Ndung'u, Thumbi organization: Max Planck Institute for Infection Biology – sequence: 5 givenname: Myron orcidid: 0000-0001-5917-9664 surname: Cohen fullname: Cohen, Myron organization: University of North Carolina At Chapel Hill – sequence: 6 givenname: Pragna surname: Patel fullname: Patel, Pragna organization: Centers for Disease Control and Prevention – sequence: 7 givenname: Gus surname: Cairns fullname: Cairns, Gus organization: PrEP in Europe Initiative – sequence: 8 givenname: Sarah E surname: Rutstein fullname: Rutstein, Sarah E organization: University of North Carolina At Chapel Hill – sequence: 9 givenname: Jintanat orcidid: 0000-0003-1369-3224 surname: Ananworanich fullname: Ananworanich, Jintanat organization: Henry M. Jackson Foundation for the Advancement of Military Medicine – sequence: 10 givenname: Colin surname: Brown fullname: Brown, Colin organization: Royal Free London NHS Foundation Trust – sequence: 11 givenname: Sarah orcidid: 0000-0003-1676-7583 surname: Fidler fullname: Fidler, Sarah email: s.fidler@imperial.ac.uk organization: Imperial College NIHR BRC |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31850686$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. COPYRIGHT 2019 International AIDS Society COPYRIGHT 2019 John Wiley & Sons, Inc. 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| DOI | 10.1002/jia2.25419 |
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| Keywords | pre-exposure prophylaxis immediate antiretroviral therapy Acute HIV infection post-exposure prophylaxis indeterminate HIV test HIV testing algorithms |
| Language | English |
| License | Attribution 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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| References | 2010; 10 2018; 320 2017; 4 2019; 10 2019; 57 2013; 368 2016; 387 2014; 25 2016; 30 2003; 17 2016; 71 2012; 367 2018; 44 2012; 205 2017; 9 2012; 54 2012; 206 2017; 75 2017; 31 2018; 5 2013; 10 2016; 316 2015; 211 2017; 76 2015; 373 2014; 52 2018; 78 2007; 21 2008; 198 2011; 365 2015; 12 2005; 191 2011; 378 2017; 20 2015; 15 2015; 3 2013; 14;9 2010; 202 2010; 363 2016; 54 2008 2009; 373 2018; 67 2017; 376 2019; 381 2017; 216 2018; 24 2016; 11 2017; 94 2012; 90 2017; 93 2015; 29 2019 2018 2016; 63 2016; 374 2017 2015 2014 2018; 94 2012; 9 2014; ;9 Manak MM (e_1_2_9_61_1) 2019; 57 e_1_2_9_75_1 e_1_2_9_31_1 e_1_2_9_52_1 e_1_2_9_73_1 e_1_2_9_79_1 e_1_2_9_10_1 e_1_2_9_35_1 e_1_2_9_56_1 e_1_2_9_77_1 e_1_2_9_12_1 e_1_2_9_33_1 e_1_2_9_54_1 Steingart KR (e_1_2_9_50_1) 2014 e_1_2_9_71_1 e_1_2_9_14_1 e_1_2_9_39_1 e_1_2_9_37_1 e_1_2_9_18_1 e_1_2_9_41_1 e_1_2_9_64_1 e_1_2_9_87_1 e_1_2_9_20_1 e_1_2_9_62_1 e_1_2_9_22_1 e_1_2_9_45_1 e_1_2_9_68_1 e_1_2_9_83_1 e_1_2_9_24_1 e_1_2_9_43_1 e_1_2_9_66_1 e_1_2_9_85_1 e_1_2_9_8_1 e_1_2_9_6_1 e_1_2_9_81_1 e_1_2_9_4_1 e_1_2_9_60_1 e_1_2_9_2_1 e_1_2_9_26_1 e_1_2_9_49_1 e_1_2_9_28_1 e_1_2_9_47_1 Branson BM (e_1_2_9_30_1) 2014 Dong KL (e_1_2_9_58_1) 2018; 5 e_1_2_9_53_1 e_1_2_9_74_1 e_1_2_9_51_1 e_1_2_9_72_1 e_1_2_9_11_1 e_1_2_9_34_1 e_1_2_9_57_1 e_1_2_9_13_1 e_1_2_9_32_1 e_1_2_9_55_1 e_1_2_9_76_1 e_1_2_9_70_1 WHO (e_1_2_9_16_1) 2014 e_1_2_9_15_1 e_1_2_9_38_1 e_1_2_9_17_1 e_1_2_9_36_1 e_1_2_9_59_1 e_1_2_9_19_1 Rodger AJ (e_1_2_9_7_1) 2018 e_1_2_9_42_1 e_1_2_9_88_1 e_1_2_9_40_1 e_1_2_9_21_1 e_1_2_9_46_1 e_1_2_9_67_1 e_1_2_9_84_1 e_1_2_9_23_1 e_1_2_9_44_1 e_1_2_9_65_1 e_1_2_9_86_1 e_1_2_9_80_1 e_1_2_9_5_1 WHO (e_1_2_9_29_1) 2015 e_1_2_9_82_1 e_1_2_9_3_1 Henderson GE (e_1_2_9_63_1) 2018; 44 Delaugerre C (e_1_2_9_78_1) 2017; 216 e_1_2_9_9_1 e_1_2_9_25_1 e_1_2_9_27_1 e_1_2_9_48_1 e_1_2_9_69_1 |
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Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally,... Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV-status... Introduction: Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes.... IntroductionKnowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally,... |
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| SubjectTerms | Acquired immune deficiency syndrome Acute HIV infection AIDS AIDS (Disease) AIDS research AIDS treatment Algorithms Anti-HIV Agents - administration & dosage Anti-HIV Agents - therapeutic use Antigens Antiretroviral agents Antiretroviral drugs Antiviral agents Care and treatment Development and progression Diagnosis Disease prevention Dosage and administration Drug resistance Drug therapy Emtricitabine FDA approval Health aspects Highly active antiretroviral therapy HIV HIV antibodies HIV infection HIV infections HIV Infections - drug therapy HIV Infections - prevention & control HIV testing algorithms HIV tests Human immunodeficiency virus Humans immediate antiretroviral therapy Immunoassay Immunoglobulins indeterminate HIV test Infections Laboratories Male Management Medical tests Medicine, Preventive Patients Post-Exposure Prophylaxis - methods post‐exposure prophylaxis Pre-Exposure Prophylaxis - methods Prevention Preventive health services pre‐exposure prophylaxis Prophylaxis Review Reviews Secondary data analysis Viral Load |
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| Title | Challenges of HIV diagnosis and management in the context of pre‐exposure prophylaxis (PrEP), post‐exposure prophylaxis (PEP), test and start and acute HIV infection: a scoping review |
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