Diagnosing Acute HIV Infection — Does Fourth-Generation Immunoassay Suffice?

In a population with high HIV prevalence, pooled nucleic acid testing of samples testing negative by fourth-generation HIV immunoassay increased AHI diagnosis by 38%.

Diagnosing acute HIV infection (AHI) is important because of the higher transmission risk during this period and the potential for early treatment to limit the HIV reservoir. Improvements in HIV testing have led to the current, fourth-generation (4thG) antigen/antibody immunoassay, which has shortened the “window period” between HIV acquisition and diagnostic-test positivity by improving the sensitivity of the antibody test and incorporating p24 antigen detection to identify early, antibody-negative infection. To further improve AHI diagnosis, some advocate pooled HIV RNA screening (nucleic-acid testing [NAT]) of negative 4thG test samples.

The Thai Red Cross AIDS Research Centre in Bangkok tested 74,334 clients by 4thG immunoassay between J…

Reviewing Author

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Diagnosing Acute HIV Infection — Does Fourth-Generation Immunoassay Suffice?

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Reviewing Author