In a webinar presented at the Association for Diagnostics of Laboratory Medicine (ADLM 2025) conference, formerly AACC, John-Paul Bettencourt, DO, MPH, MBA, AAHIVS, CPE, HIV Specialist with the American Academy of HIV medicine, and Medical Director and Chief Medical Officer of The McGregor Clinic in Fort Myers, Fla., shared clinical insights from his experience in his clinical exam room.
HIV is complex
Dr. Bettencourt’s comprehensive overview covers the complexity of HIV and how it presents, the history and evolving trends in HIV testing, and the value of the clinician-lab relationship now and in the future.
Highlighted in the presentation is the important role of high-sensitivity immunoassays in the timely diagnosis and early initiation of treatment. Current HIV treatment is effective and powerful, but much depends upon early antiretroviral treatment.
Early treatment is key
Dr. Bettencourt drove home the point that early treatment is key with statistical data and a case study. With early treatment, one patient showed a 99.8% reduction in HIV viral load (from 52,400 to 141) 22 days after initiation of treatment. This type of response is important – not only because it improves outcomes for the patient, but also, early treatment is shown to dramatically reduce transmissions to monogamous partners and the community at large.
High-sensitivity immunoassays are vital
While modern HIV testing relies on advances in nucleic acid testing (NAT), HIV antigen/antibody combination tests and HIV-1/HIV-2 antibody differentiation tests, the future of HIV testing focuses greatly on sensitivity, both for in-clinic and in-home tests. Central to this are high-sensitivity 4th-generation immunoassays that can accurately detect the p24 antigen as quickly possible after exposure.