1. HIV AIDS The Plague Tore J. Gutteberg Quality-assurance in HIV testing - using new technology

2. Quality-assurance in HIV testing Vegard Skogen, MD, PhD * *University Hospital of Northern Norway Vera Utjugova, MD^ Håkon Haaheim, MSc* Tore J Gutteberg, professor MD, PhD* Terje Aspenes, MLT* Ingeborg Lyngstad Vik. MD¤ Elena Popova, MD^ Dag Hvidsten, MD* Håkon Sjursen, professor MD, PhD# –*University Hospital of Northern Norway, Tromsø –^ AIDS-centre in Arkhangelsk, Arkhangelsk –¤ Olafia Clinic,Oslo –# Haukeland University Hospital,Bergen Quality-assurance in HIV testing

3. Aim The Norwegian government has made an initiative in order to combat communicable diseases in Russia and the Baltic region. The University Hospital of Northern Norway (UNN) and the Olafia clinic in Oslo were asked to initiate a project in order to combat the increasing HIV situation in North Western Russia. In order to reduce further spread of HIV, we have put our effort in controlling STIs. We have focused on clinical diagnosis, laboratory diagnosis, and the public health aspect with contact tracing and information. To continue our effort in controlling STI, this project will target HIV diagnostics. Quality-assurance in HIV testing Vegard Skogen, MD, PhD * Vera Utjugova, MD^ Håkon Haaheim, MSc* Tore J Gutteberg, professor MD, PhD* Terje Aspenes, MLT* Ingeborg Lyngstad Vik. MD¤ Elena Popova, MD^ Dag Hvidsten, MD* Håkon Sjursen, professor MD, PhD#

4. Diagnostic of HIV 1 Selection for testing Sampling for testing Testing –Antibody detection –Antigen detection P24 Pro HIV 1 DNA HIV 1 RNA Quality-assurance in HIV testing Confirmation of diagnosis Information to clinician

5. The Circle

6. We focus on this part of the circle

7. Quality assurance HIV 1&2 ABBOTT HIV 1 & 2 Positive & negative controlls, monitored over time Calibrators which define cut off External controlls, do we find the wxpected? For HIV 1&2 there are may external agents of deliveries.

8. The Circle All parts of this circle is important for giving the patient the correct information.

9. Improve diagnostic accuracy through –More sensitive and specific diagnostic tools –Enhance knowledge about HIV and sexual transmitted diseases –Use telemedicine as a mean to achieve both through follow up and exchange of competence HIV & Sexual transmitted Diseases Telemedicine Quality-assurance in HIV testing