From the Guidelines
Following a positive diagnostic test result for HIV, the next step is to confirm the diagnosis through Western blot or indirect immunofluorescence assay, as a positive screening test result is considered "preliminary positive" 1.
Key Considerations
- If the confirmatory test results are negative or indeterminate, follow-up testing should be performed on a blood specimen collected 4 weeks after the initial reactive HIV test result 1.
- In certain situations, such as pregnant women with preliminary positive HIV test results, antiretroviral prophylaxis should be initiated while awaiting confirmation of results 1.
- Risk assessment and counseling are crucial for individuals with positive test results, including discussion of high-risk behaviors and prevention of transmission to others 1.
Diagnostic Testing
- Rapid tests for HIV, such as the OraQuick Advance Rapid HIV-1/2 Antibody Test, can be used for detection of HIV antibodies, but may require confirmation with a whole blood rapid test due to potential false-positive results 1.
- Western blot or indirect immunofluorescence assay are used to confirm the diagnosis of HIV infection 1.
Special Populations
- Pregnant women with positive HIV test results should receive antiretroviral prophylaxis during labor to prevent perinatal transmission 1.
- Infants exposed to HIV in utero should be tested according to CDC and American Academy of Pediatrics guidelines, using diagnostic virologic assays such as HIV DNA polymerase chain reaction (PCR) or RNA PCR tests 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Next Steps After a Positive Diagnostic Test Result
The next steps after a positive diagnostic test result can vary depending on the disease and treatment options.
- For COVID-19, treatment with antiviral medications such as remdesivir 2, Paxlovid, or Molnupiravir 3 may be initiated.
- In some cases, patients may experience COVID-19 rebound after treatment with Paxlovid or Molnupiravir 3.
- For patients with COVID-19, current guidelines recommend isolation for 5 days after the first appearance of symptoms or a positive SARS-CoV-2 test, and a negative rapid antigen test (RAT) may be used to determine when an individual is no longer producing infectious virus 4.
- For tuberculosis (TB), patients who test positive for active TB but do not initiate treatment may face challenges such as poor knowledge of TB treatment, stigma, poverty, and lack of access to transport 5.
- For patients with multidrug-resistant or pre-extensive drug-resistant tuberculosis, all-oral short-course regimens may be used, and the selection of an appropriate regimen depends on various factors, including the patient's treatment preference and medical history 6.
Factors Influencing Treatment Initiation and Adherence
Several factors can influence treatment initiation and adherence, including:
- Patient-related factors, such as knowledge and awareness of the disease and treatment, social support, and personal beliefs 5
- Healthcare system-related factors, such as access to care, healthcare facility resources, and staff attitudes 5
- Disease-related factors, such as the severity of symptoms and the presence of comorbidities 3, 4
- Treatment-related factors, such as the effectiveness and tolerability of the treatment regimen, and the presence of adverse events 3, 6