The British HIV Association (BHIVA) has updated its guidelines on adult HIV testing. Despite the advances made in combatting HIV in the UK, 7% of HIV cases are estimated to be undiagnosed and 43% of those diagnosed in 2018 presented late. Thus, optimising testing is key to further progress.
The main changes compared with previous guidelines, as noted in the introduction on the BHIVA’s website, are as follows:
- Indicator condition testing recommendations now have a broader evidence base
- A new recommendation to offer testing in emergency departments in areas with high/extremely high HIV seroprevalence
- The recommendation for testing based on local diagnosed HIV seroprevalence is now divided into two categories (high and extremely high) with different recommendations, in line with National Institute for Health and Care Excellence guidance;
- A change to the window period for fourth-generation serology to 45 days.
Not all approaches described in the guidelines are relevant in all areas, the BHIVA notes. Rather, testing should be adapted according to local HIV prevalence data, populations and services.
Cost-effectiveness of testing programmes is relevant for some approaches but should not be universally applied as the cut-off threshold for instigating testing programmes.
This article originally appeared on Univadis, part of the Medscape Professional Network.
