HIV: Screening and diagnosis

Why more people should be tested for HIV

The CDC estimates that more than 1.2 million people in the United States are living with HIV.1 However, it’s estimated that 1 out of every 7 is unaware of his or her HIV infection1 and, therefore, unable to benefit from clinical care to reduce morbidity and mortality. There are patients who may be unknowingly transmitting HIV. Physicians can play an active role in

addressing this issue by screening for HIV according to current CDC recommendations.2

Everyone should be screened for HIV

The CDC recommends that everyone aged 13 to 64 years, regardless of risk factors, be screened at least once in their lifetime2

High-risk individuals should be screened at least annually

High-risk individuals include:

  • Injection drug users and their sex partners
  • People who exchange sex for money or drugs
  • Men who have sex with men (MSM)
  • People whose sex partners have HIV
  • Patients initiating treatment for tuberculosis
  • Patients seeking treatment for sexually transmitted diseases

Sexually active MSM should be tested as frequently as every 3 to 6 months

Quest Diagnostics is dedicated to providing you with innovative tools to help push HIV care into tomorrow–and beyond

Quest Diagnostics is persistently dedicated to providing the latest technology to assist healthcare providers in identifying HIV-infected patients. We were the first to standardize the 4th generation HIV-antigen/antibody screening, allowing for HIV detection up to 20 days earlier than previous generation tests. Earlier detection can help prevent new HIV infections.

Our 4th generation HIV test aligns with the HIV 4th generation screening algorithm recommended by the CDC and the APHL.3

The 4th generation HIV test has several important advantages over the 3rd generation HIV screening tests (including rapid or home tests), which only screen for HIV antibodies. The Quest Diagnostics “HIV-1/2 Antigen and Antibodies, 4th Generation, with Reflexes” assay:

  • Detects HIV p24 antigen in addition to HIV antibodies.
  • Confirms HIV-1 and HIV-2 antibodies.
  • Confirms acute HIV-1 infection using an HIV-1 RNA assay.

The CDC and APHL guidelines currently recommend the use of the 4th generation HIV screening assays for accurate diagnosis of HIV infection.3

At Quest Diagnostics, we understand that managing HIV is a journey. From screening to analyzing initial viral load results, to utilizing data informatics to address future health issues, we're dedicated to providing you with the innovative diagnostic tools to help you push HIV care into tomorrow–and beyond.

Tests available for screening and diagnosis of HIVa

Quest tests Test codesl Primary clinical use and/or differentiating factors
HIV-1/2 Antigen and Antibodies, 4th Generation, with Reflexesc 91431
  • Screens for and confirms HIV-1 and HIV-2 infection, including acute infection
  • Uses “4th generation” screening immunoassay
  • Reflexes are consistent with CDC-proposed algorithm
HIV-1/2 Antibody Differentiation (LAC) Upon
  • Differentiates between HIV-1 and HIV-2
  • Limited availability. Ask your sales representative for more information
HIV-1 RNA Qualitative 16879
  • Detects HIV-1 infection, including acute infection
  • Confirms HIV-1 infection in individuals with repeatedly reactive initial results, including those with nonreactive HIV- supplemental test results
  • Detects HIV-1 infection in infants up to 24 months of age
Watch an HIV Update for the Primary Care Provider



View all HIV healthcare provider resources.


Expert Insight on a New Algorithm for HIV Laboratory Testing


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Download the patient education brochure

APHL=Association of Public Health Laboratories; CDC=Centers for Disease Control and Prevention; HIV=human immunodeficiency virus; LAC=limited access code; RNA=ribonucleic acid.

aThis test list is not intended to be comprehensive. For additional testing options, consult the Quest Diagnostics online Test Directory

bTest codes may vary by location. Please contact your local laboratory or go to Quest Diagnostics online Test Directory for more information.

cReflex tests are performed at an additional charge and are associated with an additional CPT code(s).

References: 1. Centers for Disease Control and Prevention. HIV in the United States: At a glance. Accessed April 24, 2017. 2. Branson B, Handsfield H, Lampe M, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR-14):1–17. 3. Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory testing for the diagnosis of HIV infection: updated recommendations. June 27, 2014. Accessed April 24, 2017.