Treatment and monitoring

Supporting the health of your patients with HIV from screening through management–today and tomorrow

Quest Diagnostics is an essential collaborator in the diagnosis and management of HIV. With a persistent dedication to advancing disease management for the HIV community – we provide the tools you need to support your patients throughout the entire continuum of care. In addition to the latest assays for screening and diagnosis we offer a robust

array of state-of-the-art tests for assessing antiretroviral drug resistance, evaluating tropism, and monitoring treatment effectiveness and coinfection

HIV-1 drug resistance testing is an important component of HIV treatment. The U.S. DHHS guidelines recommend HIV-1 drug resistance testing1:

  • At entry into care to guide selection of initial ART regimen.
  • At virologic failure to assist in the selection of active drugs when changing ART regimens.

Our HIV-1 tropism assay, utilizing highly sensitive ultradeep sequencing, was demonstrated to perform comparably to a phenotypic test for predicting clinical response to MVC therapy.2

Genotypic tropism testing by ultradeep sequencing is1:

  • A rapid and cost-effective method
  • Considered an alternative to phenotypic testing

HIV: Treatment and monitoring

Soon after
ART initiation or change
HIV 4th Generation Screening Algorithm X  
CD4 count X  
HIV viral load X X
Genotypic resistance X  
CBC with differential X X*
Chemistry profile X X
Fasting lipid profile X X
Liver function including ALT, AST, ALP,
total and direct bilirubin
HbA1c or FBG X X
Urinalysis X  
Pregnancy test in women of childbearing

MI5796 10/2016

*For patients on xidovudine.

Note: This guidance is not intended to substitute for the healthcare providers learning, experience and knowledge of their patient, and their determination of how to monitor or treat their patients. Please refer to CDC Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents, Laboratory Testing

HIV tests for monitoring and treatment selectiona

Quest tests Test codesl Primary clinical use and/or differentiating factors
HIV-1 RNA, Quantitative,
Real-Time PCRc
  • Evaluates prognosis
  • Assesses effectiveness of ART and need to switch treatment regimen
  • Reportable range: 20–10,000,000 HIV-1 RNA copies/mL
HIV-1 Genotype (RTI, PI, Integrase Inhibitors)d 91692(X)
Viral load reflex:
  • Detects mutations associated with resistance to RTIs, PIs, and integrase inhibitors
HIV-1 Genotype
(RTI, PI)d
Viral load reflex:
  • Detects mutations associated with resistance to RTI and PI
HIV-1 Genotype
(Integrase Inhibitors)d
Viral load reflex:
  • Assesses mutations associated with resistance to integrase inhibitors (raltegravir, elvitegravir, and dolutegravir)
HIV-1 RNA Coreceptor Tropism, Ultradeep Sequencingd,e 94014
  • Evaluates eligibility for therapy with CCR5 antagonist (genotypic assay)
HIV-1 Proviral DNA
Coreceptor Tropism,
Ultradeep Sequencingd
  • Evaluates eligibility for therapy with CCR5 antagonist (genotypic assay) in patients with low viral load (<1,000 HIV-1 RNA copies/mL)
HLA-B*5701f 19774(X)
  • Assesses risk of abacavir hypersensitivity reaction
HIV-1 RNA, Quantitative
Real-Time PCR with Reflex
to Coreceptor Tropism,
Ultradeep Sequencing
  • Evaluates eligibility for therapy with CCR5 antagonist

Stay informed about the changing HIV landscape

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Management of HIV



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ALP=alkaline phosphatase; ALT=alanine aminotransferase; ART=antiretroviral therapy; AST=aspartate aminotransferase; CBC=complete blood count; CCR5=C-C chemokine receptor type 5; CDC=Centers for Disease Control and Prevention; CLIA=Clinical Laboratory Improvement Amendments; DHHS=Department of Health and Human Services; FBG=fasting blood glucose; FDA=Food & Drug Administration; HAV=hepatitis A virus; HbA1c=hemoglobin A1c; HBV=hepatitis B virus; HCV=hepatitis C virus; MVC=maraviroc; PCR=polymerase chain reaction; PI=protease inhibitor; RNA=ribonucleic acid; RTI=reverse transcriptase inhibitor.

aThis test list is not intended to be comprehensive. For additional testing options, consult the Quest Diagnostics online Test Center. Components of panels and reflex tests may be ordered individually.

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

cPCR is performed pursuant to a license agreement with Roche Molecular Systems, Inc.

dThis test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

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

fTyping performed by using AS-PCR with reflex to the FDA-cleared LABType® SSO Kit. The AS-PCR portion of the test was developed and its performance characteristics have been determined by Quest Diagnostics.

References: 1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Accessed April 24, 2017. 2. Kagan R, Johnson E, Siaw M, et al. A genotypic test for HIV-1 tropism combining Sanger sequencing with ultradeep sequencing predicts virologic response in treatment-experienced patients. PLoS ONE. 2012; 7(9): e46334. doi:10.1371/journal.pone.0046334.