{"id":5270,"date":"2014-06-28T17:32:44","date_gmt":"2014-06-28T21:32:44","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=5270"},"modified":"2015-06-04T14:32:17","modified_gmt":"2015-06-04T18:32:17","slug":"cdc-nixes-hiv-western-blot-in-latest-testing-guidelines","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/cdc-nixes-hiv-western-blot-in-latest-testing-guidelines\/2014\/06\/28\/","title":{"rendered":"CDC Nixes HIV Western Blot in Latest Testing Guidelines"},"content":{"rendered":"<p>Finally, it&#8217;s official &#8212; the Western blot is no longer recommended as a confirmatory test for HIV infection. From the latest\u00a0<em><a href=\"http:\/\/www.cdc.gov\/hiv\/pdf\/HIVtestingAlgorithmRecommendation-Final.pdf\" target=\"_blank\">Laboratory Testing for the Diagnosis of HIV Infection<\/a>,<\/em> updated June 27:<\/p>\n<blockquote><p>The HIV-1 Western blot and HIV-1 immunofluorescence assay, previously recommended to make a laboratory diagnosis of HIV-1 infection, are no longer part of the recommended algorithm.<\/p><\/blockquote>\n<p>It&#8217;s been clear now for years that the Western blot&#8217;s sensitivity for early HIV infection was markedly inferior to the latest generations of HIV screening tests; this difference became even starker with the approval of the combined &#8220;fourth generation&#8221; antigen\/antibody tests.<\/p>\n<p>This put clinicians in the bizarre situation of having to ignore, or disregard, the test that&#8217;s supposed to be <em>more<\/em> accurate than the screening test. Essentially every patient with a positive ELISA and negative Western blot would need\u00a0a follow-up HIV RNA test of some sort to exclude early HIV.\u00a0Read <a href=\"http:\/\/blogs.nejm.org\/index.php\/its-time-to-dump-the-hiv-western-blot\/2012\/09\/19\/\" target=\"_blank\">here<\/a> for more information.<\/p>\n<p>I&#8217;ve pasted the new recommended algorithm below. Let&#8217;s hope that labs that still use the old &#8220;reactive ELISA &#8211;&gt; Western blot confirmation&#8221; practice quickly move to this new approach. And kudos again to HIV Testing Guru (yes, that&#8217;s his official title) Bernie Branson for getting this important change into the guidelines.<\/p>\n<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2014\/06\/HIV-Testing-Algorithm-2014-jpg1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-5272\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2014\/06\/HIV-Testing-Algorithm-2014-jpg1.jpg\" alt=\"HIV Testing Algorithm 2014 jpg\" width=\"500\" height=\"342\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Finally, it&#8217;s official &#8212; the Western blot is no longer recommended as a confirmatory test for HIV infection. From the latest\u00a0Laboratory Testing for the Diagnosis of HIV Infection, updated June 27: The HIV-1 Western blot and HIV-1 immunofluorescence assay, previously recommended to make a laboratory diagnosis of HIV-1 infection, are no longer part of the [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5,8,9],"tags":[],"class_list":["post-5270","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","category-patient-care","category-policy"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5270","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=5270"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5270\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=5270"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=5270"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=5270"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}