Quest Diagnostics: Comprehensive HIV Testing Solutions
Diagnostic solutions to help drive better outcomes.
HIV Screening, Prevention, and Management
Quest Diagnostics provides comprehensive laboratory testing for the screening, prevention, and management of HIV, offering diagnostic solutions to help drive better outcomes.
Key Statistics:
- Approximately 32,000 new HIV infections diagnosed in 2022.
- An estimated 70% of new HIV infections in 2022 were among Black and Hispanic Americans.
- 1.2 million people are living with HIV in the US.
HIV screening is important for early diagnosis and treatment, and in reducing the risk of transmission.
Comprehensive Testing Menu
Quest Diagnostics offers a comprehensive testing menu to support every step in the HIV care continuum:
SCREEN
Combination antigen and antibody testing for earliest identification of HIV infection.
- Identifies HIV early to maximize treatment options.
- The Centers for Disease Control (CDC) recommends screening all patients age 13-65 for HIV at least once, regardless of their risk level, using an opt-out approach.
CARE
Comprehensive test offerings to support ongoing HIV management.
- Immune status and viral load monitoring.
- Antiretroviral therapy (ART) selection, drug resistance, and tropism testing.
- Identification of coinfections with other blood-borne pathogens (e.g., HBV, HCV).
PREVENT
CDC guideline-recommended PrEP testing.
- Flexible testing menu tailored to patients' unique needs.
- Billing and reimbursement challenges mitigated by updated test naming and coding.
Diagnostic Screening for Every Adult Patient
The appropriate testing can help prevent transmission and improve outcomes. The CDC and HIV.gov recommend the following screenings for HIV:
- One-time testing is recommended for all individuals age 13-65.
- People engaging in risky behaviors should get tested at least once every year.
- Screening everyone helps patients make informed decisions, combat the spread of the disease, and seek treatment sooner.
- Take advantage of preventive measures that help limit the transmission of infection.
Quest Diagnostics offers a comprehensive set of HIV screening and diagnostic tools to help patients make confident, informed decisions throughout the care continuum, from routine screening to treatment monitoring.
CDC recommends 4th generation antigen/antibody assays for detection and diagnosis.
HIV Screening Options:
| Test Code | Test Name | Use Case |
|---|---|---|
| 91431 | HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes | Helps diagnose HIV-1 and HIV-2 infection, including acute infection, and differentiate HIV-1 from HIV-2. |
| 14312 | HIV-1 and HIV-2 RNA, Qualitative, Real-Time PCR | Detects HIV-1 RNA in human serum and plasma by PCR as an aid in diagnosis of HIV-1 infection. |
| 8401 | HIV-1 DNA, Qualitative, PCR | For use in conjunction with clinical presentation and other laboratory markers of disease progress in the clinical management of patients infected with HIV-1. |
Caring for the Patient with HIV
Quest provides the full array of testing to help guide every step of the care continuum.
Determining Immune Status and Viral Load
CD4+ T-cell count is the most valuable indicator of immune status and predictor of disease progression and survival in patients who test HIV-positive. CD4 counts should be measured at diagnosis and monitored every 3-6 months in patients who do not immediately start antiretroviral therapy (ART).
HIV-1 viral load also helps determine risk of disease progression, informs treatment selection, and provides a baseline for assessing treatment response. Once ART is initiated, HIV viral load is an important indicator of therapeutic efficacy.
For those who have tested HIV-positive and completed 6 months or more of antiretroviral treatment, testing can help determine when their viral load reaches the point where there is no longer risk of transmission.
HIV - If someone is on effective treatment they can't pass it on. (U=U) Undetectable = Untransmittable
Achieve and maintain an undetectable viral load and prevent further transmission.
HIV Care Testing Options:
| Test Code | Test Name | Use Case |
|---|---|---|
| 40085 | HIV-1 RNA, Quantitative, Real-Time PCR | For the clinical management of patients with HIV-1 infection as an aid in assessing prognosis and monitoring the effects of antiretroviral therapy. |
| 8360 | Lymphocyte Subset Panel 5 includes % CD4, absolute CD4+ cells, absolute lymphocytes | For establishing baseline CD4 level, monitoring treatment progress, and to facilitate differential diagnoses between congenital and acquired immunodeficiency diseases. |
Selecting and Adapting ART
| Test Code | Test Name | Use Case |
|---|---|---|
| 91691 | HIV-1 RNA, Quantitative, Real-Time PCR with Reflex to Genotype (RTI, PI, Integrase) | For monitoring viral load in patients undergoing antiretroviral therapy and with automatic reflex to drug resistance testing in patients failing to achieve or maintain virologic suppression. |
| 94807 | HIV-1 Resistance, Proviral DNA (RTI, PI, Integrase inhibitors) | For detecting drug-resistant mutations in virologically suppressed patients and assisting in modification of treatment regimens. |
| 91692 | HIV-1, Genotype (RTI, PI, Integrase inhibitors) | For detecting drug-resistant-associated mutations to reverse transcriptase, protease, and integrase genes. |
| 34949 | HIV-1 Genotype | For identifying drug-resistant mutations to predict antiretroviral drug resistance before initiation of therapy and managing patients experiencing virologic failure while on therapy. |
| 16868 | HIV-1 Integrase Genotype | For detecting drug-resistant-associated mutations in integrase genes. |
| 94014 | HIV-1 Coreceptor Tropism, Ultradeep Sequencing | For determining eligibility for treatment with CCR-5 antagonists. |
| 91299 | HIV-1 Coreceptor Tropism, Proviral DNA | For determining eligibility for treatment with CCR-5 antagonists in patients who are virologically suppressed. |
| 19774 | HLA-B*5701 Typing | Assess risk of abacavir hypersensitivity reaction. |
ª For Quest's full menu offering of HIV tests, please see the online test directory.
Diagnostic Testing Solutions that Support a Pathway to Pre-Exposure Prophylaxis (PrEP)
Our HIV PrEP test offerings include all the most recent CDC guideline-recommended tests to determine clinical eligibility and to monitor patients while they are on PrEP. Our flexible menu makes testing simple to meet your patients' needs.
The Quest PrEP Testing Difference:
- Flexible testing options to choose the right test based on your patients' unique requirements.
- Billing and reimbursement challenges are mitigated by our updated menu offering.
- Gender-inclusive testing language designed to cater to all patients, regardless of gender.
- Accessible testing options with approximately 2,400 patient service centers and in-office phlebotomists to help patients get the tests they need, when they need them.
The CDC reports that PrEP can reduce the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%.
PrEP HIV Testing Options:
| Test Code | Test Name | Use Case |
|---|---|---|
| 13590 | PrEP HIV-1/2 Antigen and Antibodies, Fourth Generation, Screen and HIV-1 RNA | For clinician determination of HIV status in patients with recent or ongoing antiretroviral prophylaxis use. |
| 13595 | PrEP HIV-1/2 Antigen/Antibodies, 4th Generation, Reflex to Differentiation | For clinician determination of HIV status in patients without recent or ongoing antiretroviral prophylaxis use who are considering initiating PrEP. |
| 13600 | PrEP HIV-1 RNA, Qualitative Real-Time PCR | For use as part of a multistep algorithm for determination of HIV status in patients being considered for PrEP with likely HIV exposure but negative or indeterminate HIV antibody results. |
| 13670 | PrEP HIV-1/2 Antigen and Antibodies, Fourth Generation, with Reflexes | For diagnosis of HIV-1 and HIV-2 infection, including acute infection, and to differentiate HIV-1 from HIV-2 in patients who have not taken HIV PrEP. |
| 13660 | PrEP HBV Triple Screen Panel with Reflexes includes HBV Surface Antigen with Reflex Confirmation; HBV Core Antibody, Total, with Reflex to IgM; HBV Surface Antibody, Quantitative | For screening for HBV in patients who are considering taking or currently taking HIV PrEP. |
| 13667 | PrEP Hepatitis C Antibody with Reflex to HCV, RNA, Real-Time PCR | For screening for HBC in patients who are considering taking or currently taking HIV PrEP. |
| 13698 | PrEP RPR (Diagnosis) with Reflex Titer and Treponema pallidum Antibody, IA | As part of a screening regimen for STIs in patients who are considering taking or currently taking HIV PrEP. |
| 13701 | PrEP Chlamydia/Neisseria gonorrhoeae RNA, TMA, Urogenital | As part of a screening regimen for STIs in patients who are considering taking or currently taking HIV PrEP. |
| 13697 | PrEP Creatinine | For evaluating kidney function in patients who are considering taking or currently taking HIV PrEP. |
| 13696 | PrEP hCG, Total, Quantitative | As part of an overall screening regimen for patients who are considering taking or currently taking HIV PrEP. |
| 70051 | Chlamydia/Neisseria gonorrhoeae RNA, TMA, Throat | As part of a screening regimen for STIs that may infect the oral/pharyngeal cavity of sexually active individuals. |
| 16506 | Chlamydia/Neisseria gonorrhoeae RNA, TMA, Rectal | As part of a screening regimen for STIs that may infect the anal/rectal canal of sexually active individuals. |
3 out of 5 adults at risk for HIV are missing out on potentially lifesaving preventive treatments.
Benefits of Teaming with Quest Diagnostics
Quest Diagnostics is the largest provider of diagnostic testing insights and information services, offering:
- Guideline-based solutions driven by industry-leading expertise and investment.
- Medical and scientific support from an extensive team of MDs, PhDs, and other diagnostics experts.
- Quanum® online lab services to simplify ordering with enhanced results, transparent pricing, and billing support.
- In-network access with most private insurance plans, Medicare, and Medicaid, which helps to minimize billing and reimbursement challenges.
- Financial assistance programs available to eligible persons when affordability is a barrier to appropriate care.
- Convenient sample collection at 2,400 Patient Service Centers across the US or performed by in-office phlebotomists.
Learn more. Talk to your Quest sales representative or visit QuestHIVTesting.com.
References
- HIV.gov. US Statistics. Updated August 15, 2024. Accessed December 19, 2024. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
- CDC. Clinical testing guidance for HIV. Updated September 10, 2024. Accessed November 15, 2024. https://www.cdc.gov/hivnexus/hcp/diagnosis-testing/index.html
- HIV.gov. Who should get tested? Updated March 6, 2023. Accessed December 19, 2024. https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/who-should-get-tested
- Branson BM, Owen SM, Wesolowski LG, et al. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Centers for Disease Control and Prevention. doi:10.15620/cdc.23447
- Etami Y, Zaheer MA, Marcus JL, Calabrese SK. Accuracy of HIV risk-related information and inclusion of undetectable=untransmittable, pre-exposure prophylaxis, and post-exposure prophylaxis on US Health Department websites. AIDS Patient Care STDs. 2023;37(9):425-427. doi:10.1089/apc.2023.0150
- Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Updated September 21, 2022. Accessed October 7, 2024. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf
- CDC. Undetectable = untransmittable. Updated August 19, 2024. Accessed November 19, 2024. https://www.cdc.gov/global-hiv-tb/php/our-approach/undetectable-untransmittable.html
- CDC. Clinical care of HIV. Updated April 24, 2024. Accessed November 26, 2024. https://www.cdc.gov/hivnexus/hcp/clinical-care/index.html
- National Institutes of Health. Pre-Exposure Prophylaxis (PrEP). Updated December 11, 2023. Accessed December 19, 2024. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/pre-exposure-prophylaxis-prep
Test codes may vary by location. Please contact your local laboratory for more information.
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