Office Testing for Infectious Diseases Can Boost Clinical Care

Children younger than 6 years may not even make the heterophile antibodies, so a negative test on a young child shouldn't affect clinical decision-making, Dr. Krilov said. “The antibodies are detected in up to 85% of older kids and adolescents, but [in] 40% or less of those younger than 4 years. If you have a patient of the appropriate age and symptoms, and the test is negative, treat it as early disease and test again in 1–2 weeks. Or you have the option of sending to the lab for specific serology.”

Dr. Krilov also spoke about in-office HIV testing. Two CLIA-waived kits are available and give results in 20 minutes. “It's useful in some clinical settings, since it allows more people to be tested … but they don't give a complete diagnostics, so a positive test must always be confirmed by the Western blot analysis. The other part of HIV testing is, if you do the test, it needs to be done in conjunction with counseling and hooking patients into appropriate follow-up.”