Integrating HIV, hepatitis C virus (HCV) and syphilis testing is a laboratory best practice that improves detection of common co-infections and expedites treatment, but integrating these tests is not always easy. Each health department is unique, so they must take a customized approach to implementation based on their distinct set of requirements. To succeed, a health department and its public health laboratory must share common goals and be willing to work together to forge a mutually acceptable agreement.
Until recently, laboratories aiming for test integration had no venue to discuss the practical issues involved. This changed in 2019 when APHL sponsored a one-day workshop prior to the HIV Diagnostics Conference to review HIV, HCV and syphilis testing algorithms; discuss diagnostic testing challenges for each of the three pathogens; and compare recommended methods and protocols to those in use at attendees’ laboratories.
Modeled upon similar APHL workshops for influenza, the workshop brought together representatives from 20 states, the three CDC divisions that funded the workshop and professionals from related areas of public health. Participants exchanged information on common issues such as educating providers and submitters about HIV and syphilis algorithms, appropriate use of nucleic acid testing (NAT) for confirmation of HIV infection, access to ribonucleic acid (RNA) testing for confirmation of HIV and HCV infection, and selection of the optimal syphilis algorithm. Participants like Mary Louise Walmsley, MT(ASCP)—a public health microbiologist in the Alaska State Virology Laboratory’s Department of Immunology—were enthusiastic about the workshop: “Because of the workshop, new and pertinent information regarding HCV and syphilis will be incorporated into the programs at our facility. This was a fantastic workshop, and I hope APHL hosts another one.”
Pending available funding, APHL hopes to continue to sponsor this workshop at future conferences, with a possible return to the HIV Diagnostics Conference, which is held every two to three years. However, given this interval between conferences, APHL is also exploring options at conferences of partner organizations whose work relates to HIV, HCV and STD testing.
In related efforts, APHL has urged the US Department of Health and Human Services (HHS) to develop an STD Federal Action Plan that aligns with other HHS initiatives to combat overlapping epidemics. Additionally, APHL is supporting the Ending the HIV Epidemic plan and efforts to eliminate HCV.