Chairperson:

Carol Pagliaro
Secretary:
Rick Lambert
 
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New York City Point-of-Care Network

Meeting Minutes

What’s New in POC STD Testing

Wednesday, June 8, 2005

1:00 p.m.

Roosevelt Hospital 2nd Floor Conference Room

 

In Attendance:         

  • Dr. Barry Elkin

  • Lori Marchand

  • Dezna Smikwe

  • Theresa Andrews

  • Elizabeth Vadasdi

  • Carol Pagliaro

  • Rick Lambert

Presenters:             

  • Donna Casellas

  • Dr. Bernard Branson – Orasure Technologies

  • Carl Olesh

  • Julie Fadel – Genzyme

Rapid HIV Testing – Dr. B. Branson

Advancing HIV Prevention thru:

 

1.      Voluntary Testing

2.      New methods for dx HIV infection

3.      Preventing new infection

4.      Reducing prenatal infections

 

Currently 4 approved rapid HIV tests. 2 waived are:

 

1.      Uni-Gold Recombigen:

  • Screens for HIV-1 only

  • Results in 10 minutes

  • Control doesn’t validate addition of specimen

2.      Ora-Quick Advance

  • Screens for HIV-1 & 2

  • Results in 20-40 mins

  • Anti Human IgG as internal control

 

NYSDOH HIV Testing Guidelines

 

1.      Streamline HIV counseling in all settings

  • Provide information

  • Simple informed consent

1.      Integrate sensitive testing in medical care settings

  • Prenatal testing for all programs

  • Offer routinely regardless perceived risk

  • Lower threshold for recommended testing

  • Provide rapid testing in STD clinics, family planning clinics, drug treatment centers

  • Provide rapid testing in primary care sites: hospitals, emergency departments

2.      Adapt rapid testing

 

CDC recommendation: A patient with a positive OraQuick test result and a negative EIA confirmatory test result should have a repeat EIA confirmatory test performed within 2-4 weeks.

 

Websites:

For information on 2005 Guidelines including revised information and consent forms: www.health.state.ny.us/nysdoh/hivaids

 

For general and technical information on rapid HIV testing: www.cdc.gov/hiv/rapid_testing

 

NY State Questions: HIVET@health.state.ny.us

 

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Bacterial vaginosis – Julie Fadel

Bacterial vaginosis (BV) disease overview:  a condition where the normal balance of bacteria in the vagina (Lactobacillus sp.) is disrupted and replace by an overgrowth of pathogenic bacteria (Bacteroides spp, Prevotella spp, Gardnerella vaginalis and Mobiluncus spp.)

 

Complications from untreated BV include increased risk of preterm labor & birth, or low birth weight; Pelvic Inflammatory Disease (PID); increased susceptibility to other STD’s including HIV.

 

Rapid Diagnosis: Genzyme OSOM BVblue is an enzyme activity test that detects sialidase activity from vaginal swabs.  Sialidase is produced by Bacteroides spp, Prevotella spp, Gardnerella vaginalis and Mobiluncus spp

 

Test principle: Genzyme OSOM BVblue

  • Contains chromogenic substrate of sialidase

  • Substrate undergoes chemical reaction to yield sialic acid and chromogenic component when exposured to bacterial sialidase in patient sample

  • A positive test result is the presence of a blue color with the addition of the Developer Solution (NaOH)

  • A negative test result is the presence of a yellow color with the addition of the Developer Solution (NaOH)

  • BV treatment: metronidazole or clindamycin

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Trichomoniasis – Julie Fadel

Trichomoniasis disease overview:  a sexually transmitted disease caused by Trichomonas vaginalis.  It resides in the lower genital tract of females and urethra and prostate of males.

 

Complications from untreated trichomoniasis include increased risk of preterm labor & birth; low birth weight; neonatal infection; increased susceptibility of other STD’s including HIV; cervical cancer

 

Rapid Diagnosis: OSOM Trichomonas Rapid Test (CLIA waived) is an immunochromatogenic assay that uses “lateral flow test stick format” to detect Trichomonas antigens directly from vaginal swabs.

 

Test Principle: OSOM Trichomonas Rapid Test

  • Patient vaginal swab is mixed in Sample Buffer

  • The Test Stick is placed in the sample mixture which migrates along the membrane surface

  • Trichomonas present in the sample mixture binds to a “capture antibody” and “detector antibody” to produce a blue color at the Test Line position.

  • A positive test result is the presence of a blue line at the Test Line position and a red line at the Control Line position.

  • A negative test result is the absence of a blue line at the Test Line position with the presence of a red line at the Control Line position.

  • Trichomoniasis Treatment:  metronidazole or tinidazole

 

Sept. 14, 2005 was selected as next meeting date.

 

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