Cost-effectiveness of routine use of pooled nucleic acid amplification testing
Detection of acute HIV infection (the stage of disease immediately after HIV acquisition but before HIV antibodies are detectable) with pooled nucleic acid amplification testing (that detects the presence of HIV genetic material in the blood before antibodies are detectable) is feasible but not cost-effective in all settings. Rather, pooled nucleic acid amplification testing after testing for antibodies with third-generation enzyme immunoassays (which can detect the first antibody to appear after infection) or rapid testing is only cost-effective when targeted to settings with very high HIV incidence, such as clinics that serve men who have sex with men (MSM). These are the findings of a study by Angela Hutchinson from the Centres for Disease Control and Prevention, Atlanta, Georgia, USA, and colleagues published in this week's PLoS Medicine...