1. HIV-1/HIV-2 COMBINATION SCREENING AND OUTCOMES OF FOLLOW UP William R. Oleszko, Ph.D. Associate Director, Public Health Laboratory Department of Health and Mental Hygiene New York City

2. HIV ANTIBODY TESTING – 2004 April 2004: Initiated use of new HIV antibody screening assay BioRad’s HIV-1/HIV-2 Plus “O” EIA April – December 2004: 73,955 specimen submissions 96.5% NEGATIVE for antibody to HIV-1/HIV-2 3.3% POSITIVE for antibody to HIV-1 0.2% INCONCLUSIVE for antibody to HIV-1

4. HIV-2 ANTIBODY YEARSSTUDYSUBJECTAVERAGE HIV-2 CASES/YEAR AVERAGE SUBMISSIONS/ YEAR 1988 – 1993 ProspectiveHIV-1 Inconclusive 5 158,959 1994 – 1997 Retrospective HIV-1 Inconclusive + AOB Africa 12 156,020 1998 – 2004 ProspectiveAll Submissions38 120,200

5. CATEGORIES FOR SPECIAL STUDY Atypical but reactive HIV-1 Western blot banding pattern Inconclusive: pregnant or two HIV-1 inconclusives within one month Area of birth = Africa/Asia HIV-2 reactivity AIDS symptoms and HIV antibody negative Child of HIV positive mother HIV Positive, no ART, undetectable viral load, declining CD4 HIV positive, on ART, undetectable viral load, declining CD4 OraQuick preliminary positive confirmatory result = inconclusive

6. ASSAYS PERFORMED ON SPECIAL STUDY SPECIMENS Current: HIV-1/HIV-2 Multispot Rapid EIA HIV V3 serotype CD4/CD8 T-cell Enumeration HIV-1 DNA PCR HIV-2 DNA PCR Viral load - HIV-1 RNA PCR & HIV-1 bDNA Future: HIV Genotyping/Resistance Testing

7. SEEK AND YE SHALL FIND!

8. Public Health Laboratory PHL: Sara T. Beatrice, Ph.D., Assistant Commissioner Retrovirology Laboratory: Amado Punsalang, Jr., Ph.D. Robert Pirillo – Community Coordinator Mona El-Fishawy - HIV Screening Lab Mohammad Younis – HIV Supplemental Testing Lab Ed Lee. Ph.D. – HIV PCR Lab Orlin Trochev, MD, Ph.D. – HIV Genotyping/Resistance Lab