Does HIV RNA Testing to Monitor PrEP Add Value?

Not according to a real-world cohort study — antigen/antibody testing should be enough.

The 2021 CDC Guidelines for HIV PrEP recommend both HIV antigen/antibody (Ag/Ab) and RNA testing at PrEP initiation and for routine follow-up, but data to support RNA testing to monitor PrEP use in clinical practice are lacking. To infer the impact of surveillance RNA testing, investigators assessed the agreement between same-day HIV Ag/Ab and RNA results in a real-world cohort of almost 16,000 persons on oral PrEP before the 2021 guideline update relative to almost 15,000 persons after the update.

Results were as follows:

HIV RNA testing during follow-up increased almost 10-fold.
Overall agreement between Ag/Ab and RNA results remained high at nearly 100%.
Positivity rates of Ag/Ab and HIV RNA testing at PrEP initiation did not change after th…

Reviewing Author

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Does HIV RNA Testing to Monitor PrEP Add Value?

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Reviewing Author