In this section
@article{Elliott:2025:10.1097/COH.0000000000000919,
author = {Elliott, T and Bradshaw, D and Fidler, S},
doi = {10.1097/COH.0000000000000919},
journal = {Current Opinion in HIV and AIDS},
pages = {228--235},
title = {HIV diagnosis during acute infection: implications of long-acting preexposure prophylaxis and other evolving challenges},
url = {http://dx.doi.org/10.1097/COH.0000000000000919},
volume = {20},
year = {2025}
}
TY - JOUR
AB - Purpose of review Tests for HIV may perform differently in some circumstances such as with preexposure prophylaxis (PrEP) or other HIV prevention agents. Testing algorithms may not account for this, with a risk of false negative or positive HIV results. In this review we have explored the challenges of HIV testing in these special circumstances.Recent findings Long-acting injectable PrEP using cabotegravir or lenacapavir has been studied in large randomized controlled trials (HPTN083/084 and PURPOSE1/2 respectively). Injectable PrEP was significantly more efficacious than oral PrEP, but infections still occurred risking the emergence of HIV drug-resistance. HIV diagnostic test results were atypical in those receiving injectable PrEP, with low or undetectable HIV viral loads, delayed or diminished antibody, and HIV detection assays reverting from reactive to unreactive; so-called long acting early viral inhibition (LEVI) syndrome. In these cases, missed or delayed HIV diagnoses could be reduced with the use of HIV nucleic acid amplification tests in addition to routine testing, but this remains unfeasible in many settings.Summary Finding HIV testing strategies that are affordable and practical in low- and middle-income countries that can accurately diagnose HIV in the context of HIV prevention is of high importance, but more research is needed in this area.
AU - Elliott,T
AU - Bradshaw,D
AU - Fidler,S
DO - 10.1097/COH.0000000000000919
EP - 235
PY - 2025///
SN - 1746-630X
SP - 228
TI - HIV diagnosis during acute infection: implications of long-acting preexposure prophylaxis and other evolving challenges
T2 - Current Opinion in HIV and AIDS
UR - http://dx.doi.org/10.1097/COH.0000000000000919
VL - 20
ER -