STI Testing Beyond Syphilis: HIV Algorithms, GC/CT NAAT, and the Herpes Serology Dilemma
STI Testing Beyond Syphilis: HIV Algorithms, GC/CT NAAT, and the Herpes Serology Dilemma The testing rules that have changed, the test you probably shouldn't be ordering, and the window periods that still trip everyone up. The syphilis post covered one STI in depth. But the full STI panel has its own set of testing nuances, window periods, and pitfalls that new NPs need to master. HIV testing has evolved dramatically with 4th-generation assays, gonorrhea/chlamydia NAAT is site-specific, and herpes serology is the test that causes more unnecessary distress than almost any lab in primary care. HIV Testing: The Modern Algorithm 4th-Generation Ag/Ab Combo Test (The Standard) The current recommended initial screen is the 4th-generation HIV-1/2 antigen/antibody combination immunoassay . It detects both HIV antibodies AND p24 antigen, shortening the window period to approximately 2–4 weeks after exposure (compared to 3–12 weeks for older antibody-only tests). The CDC R...