title: Six-week follow-up after HIV-1 exposure: a position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy.
abstract: In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.
authors.affiliation: a Public Health Agency of Sweden , Solna .|b Unit of Infectious Diseases, Department of Medicine , Karolinska Institutet , Stockholm .|c Department of Infectious Diseases , Karolinska University Hospital , Stockholm .
authors.forename: Hans
authors.initials: H
authors.lastname: Gaines
authors.affiliation: d Department of Microbiology , Tumor and Cell Biology, Karolinska Institutet , Stockholm .|e Department of Clinical Microbiology , Karolinska University Hospital , Stockholm .|f Swedish Reference Group for Antiviral Therapy , Stockholm .
authors.forename: Jan
authors.initials: J
authors.lastname: Albert
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Maria
authors.initials: M
authors.lastname: Axelsson
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Torsten
authors.initials: T
authors.lastname: Berglund
authors.affiliation: f Swedish Reference Group for Antiviral Therapy , Stockholm .|g Department of Infectious Diseases , Sahlgrenska Academy, University of Gothenburg , Gothenburg .
authors.forename: Magnus
authors.initials: M
authors.lastname: Gisslén
authors.affiliation: c Department of Infectious Diseases , Karolinska University Hospital , Stockholm .|e Department of Clinical Microbiology , Karolinska University Hospital , Stockholm .|f Swedish Reference Group for Antiviral Therapy , Stockholm .|h Department of Laboratory Medicine, Division of Clinical Microbiology , Karolinska Institutet , Stockholm .
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
authors.affiliation: i Department of Infectious Diseases , Södersjukhuset Venhälsan , Stockholm .
authors.forename: Anders
authors.initials: A
authors.lastname: Blaxhult
authors.affiliation: e Department of Clinical Microbiology , Karolinska University Hospital , Stockholm .
authors.forename: Gordana
authors.initials: G
authors.lastname: Bogdanovic
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Maria
authors.initials: M
authors.lastname: Brytting
authors.affiliation: f Swedish Reference Group for Antiviral Therapy , Stockholm .|j Clinic of Infectious Diseases, County Hospital of Västmanland , Västerås .
authors.forename: Christina
authors.initials: C
authors.lastname: Carlander
authors.affiliation: f Swedish Reference Group for Antiviral Therapy , Stockholm .|k Department of Infectious Diseases , University of Lund, Skåne University Hospital , Malmö .
authors.forename: Leo
authors.initials: L
authors.lastname: Flamholc
authors.affiliation: l Department of Communicable Disease Control and Prevention , Region Västra Götaland , Gothenburg .
authors.forename: Per
authors.initials: P
authors.lastname: Follin
authors.affiliation: m National Board of Health and Welfare , Stockholm .
authors.forename: Axana
authors.initials: A
authors.lastname: Haggar
authors.affiliation: n Department of Communicable Disease Control and Prevention , Skåne , Malmö .
authors.forename: Per
authors.initials: P
authors.lastname: Hagstam
authors.affiliation: o Department of Clinical Microbiology and Infectious Diseases , Kalmar County Hospital , Kalmar .
authors.forename: Marcus
authors.initials: M
authors.lastname: Johansson
authors.affiliation: f Swedish Reference Group for Antiviral Therapy , Stockholm .|p Department of Pediatrics , Karolinska University Hospital , Stockholm .|q Department of Clinical Science , Intervention and Technology, Karolinska Institute , Stockholm .
authors.forename: Lars
authors.initials: L
authors.lastname: Navér
authors.affiliation: r Swedish Work Environment Authority , Stockholm , and.
authors.forename: Jenny
authors.initials: J
authors.lastname: Persson Blom
authors.affiliation: e Department of Clinical Microbiology , Karolinska University Hospital , Stockholm .
authors.forename: Agneta
authors.initials: A
authors.lastname: Samuelson
authors.affiliation: m National Board of Health and Welfare , Stockholm .
authors.forename: Helena
authors.initials: H
authors.lastname: Ström
authors.affiliation: s Department of Laboratory Medicine , Clinical Microbiology, Örebro University Hospital , Örebro , Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Sundqvist
authors.affiliation: c Department of Infectious Diseases , Karolinska University Hospital , Stockholm .
authors.forename: Veronica
authors.initials: V
authors.lastname: Svedhem Johansson
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Karin
authors.initials: K
authors.lastname: Tegmark Wisell
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Anders
authors.initials: A
authors.lastname: Tegnell
authors.affiliation: a Public Health Agency of Sweden , Solna .
authors.forename: Rigmor
authors.initials: R
authors.lastname: Thorstensson
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods; D042241:Early Diagnosis; D015483:HIV Antibodies / Q000097:blood*; D015488:HIV Antigens / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D015498:HIV-2 / Q000302:isolation & purification; D006282:Health Personnel; D006801:Humans; D016273:Occupational Exposure; D056990:Post-Exposure Prophylaxis / Q000379:methods*; D012698:Serologic Tests / Q000379:methods*; D013548:Sweden; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D015483:HIV Antibodies; D015488:HIV Antigens
keywords: HIV follow-up window period; HIV-1; HIV-2; prophylaxis