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LABNET LABNET

CURRENT HIV TESTING ACTIVITIES IN PACIFIC JURISDICTIONS

CURRENT HIV TESTING ACTIVITIES IN PACIFIC JURISDICTIONS

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HIV SCREEN TESTINGHIV SCREEN TESTING

• Using HIV rapid screening test kits that have been recommended by WHO and further evaluated by Lab Net partner, NRL-Melbourne, on specimens from Fiji

• Some labs use an ELISA test for initial screening test (e.g. Abbott HIV 1 / 2, Vidas)

• Two kits that were evaluated: Serodia-Fujirebio and Determine-Abbott

• Initial recommendation from NRL Either test could be used for first-line screening A positive Serodia result confirmed with Determine, but not positive Determine

with Serodia NRL would look at y possibly evaluating additional screen tests (UniGold,

Capillus), on specimens from the Pacific region

• All current screen testing is performed in lab-based settings

• Using HIV rapid screening test kits that have been recommended by WHO and further evaluated by Lab Net partner, NRL-Melbourne, on specimens from Fiji

• Some labs use an ELISA test for initial screening test (e.g. Abbott HIV 1 / 2, Vidas)

• Two kits that were evaluated: Serodia-Fujirebio and Determine-Abbott

• Initial recommendation from NRL Either test could be used for first-line screening A positive Serodia result confirmed with Determine, but not positive Determine

with Serodia NRL would look at y possibly evaluating additional screen tests (UniGold,

Capillus), on specimens from the Pacific region

• All current screen testing is performed in lab-based settings

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HIV SCREEN TESTINGHIV SCREEN TESTING

• EQA is available for Serodia and Determine, provided by PPTC-New Zealand

• Training for kit usage: workshops at off-site facilities (NRL, PPTC, etc), training sessions in-country (e.g. WHO, Mataika House), on-the-job training by lab staff

• Test kits procurement: in-country procurement mechanisms, from UN/WHO direct procurements, from SPC-Global Fund-Fiji Pharmaceutical arrangement, NGO’s and other donor groups

• Negative results are reported to requesting site

• Positive results: reported as pending confirmation and sent to reference lab for confirmation

• EQA is available for Serodia and Determine, provided by PPTC-New Zealand

• Training for kit usage: workshops at off-site facilities (NRL, PPTC, etc), training sessions in-country (e.g. WHO, Mataika House), on-the-job training by lab staff

• Test kits procurement: in-country procurement mechanisms, from UN/WHO direct procurements, from SPC-Global Fund-Fiji Pharmaceutical arrangement, NGO’s and other donor groups

• Negative results are reported to requesting site

• Positive results: reported as pending confirmation and sent to reference lab for confirmation

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HIV CONFIRMATION TESTINGHIV CONFIRMATION TESTING

• US affiliated jurisdictions must follow CDC requirement and have a Western Blot

• Non-US jurisdictions can utilize the recommendation of a 2 ELISA test confirm (e.g. Enzygnost-Dade Behring and Vironostika-Biomeriuex at Mataika House)

• Labs refer positive screen samples to the most appropriate reference lab

• Current confirmation labs:

• US affiliated jurisdictions must follow CDC requirement and have a Western Blot

• Non-US jurisdictions can utilize the recommendation of a 2 ELISA test confirm (e.g. Enzygnost-Dade Behring and Vironostika-Biomeriuex at Mataika House)

• Labs refer positive screen samples to the most appropriate reference lab

• Current confirmation labs:

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Country / Territory Reference Lab / Location

US Affiliated Islands Diagnostic Lab Services or Hawaii State Lab: Honolulu, Hawaii

Cook Islands, Samoa, Tonga LabPlus: Auckland, New Zealand

Fiji-all sites in-country Mataika House (Public Health) Lab: Suva, Fiji

Kiribati Mataika House Lab: Suva, Fiji

Nauru Queensland Medical Lab: Brisbane, Australia

Solomon Islands Royal Brisbane Hospital: Brisbane, Australia

Vanuatu Institute Pasteur: New Caledonia

Wallis & Futuna Institute Pasteur: New Caledonia

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MAJOR ISSUES WITH CURRENT SCREEN AND CONFIRMATION TESTING

MAJOR ISSUES WITH CURRENT SCREEN AND CONFIRMATION TESTING

• Delay in HIV results to requesting sites (hospitals, clinics, etc)

• Inconsistent performance and maintenance of test competency and EQA performance for all performing lab techs

• Poor and non-user friendly procurement practices Lab staff, government procurement systems, donor agencies Many kits expire; kits are frequently out of stock

• Delay in shipping specimens to reference labs Inadequate resources and arrangements for courier or shipper Inconsistent availability of trained personnel to process shipments

• Delay in HIV results to requesting sites (hospitals, clinics, etc)

• Inconsistent performance and maintenance of test competency and EQA performance for all performing lab techs

• Poor and non-user friendly procurement practices Lab staff, government procurement systems, donor agencies Many kits expire; kits are frequently out of stock

• Delay in shipping specimens to reference labs Inadequate resources and arrangements for courier or shipper Inconsistent availability of trained personnel to process shipments