Improved Detection of Acute HIV Infection in High-Prevalence Populations

Diagnosis of acute HIV infection is challenging because of the lack of HIV antibodies in the acute stage and requires the use of assays that detect HIV-1 RNA or p24 antigen. Fourth-generation assays that detect both p24 antigen and anti-HIV antibodies might detect acute HIV infection, but this has not been validated against pooled HIV RNA testing after a negative HIV antibody screen. Now, investigators from the CDC have tested the use of a laboratory-based fourth-generation assay (Abbott Architect) and also performed pooled HIV RNA testing in individuals who were HIV-negative on a point-of-care rapid HIV test (OraQuick) at sites in New York, California, and North Carolina.

A total of 86,836 participants (median age, 29; 75% men; 52% men who …