Human Immunodeficiency Virus Diagnostic Testing: 30 Years of Evolution.

Human Immunodeficiency Virus Diagnostic Testing: 30 Years of Evolution.

Alexander Thomas S

Clinical and vaccine immunology : CVI

2016

2016-04

A concern during the early AIDS epidemic was the lack of a test to identify individuals who carried the virus. The first HIV antibody test, developed in 1985, was designed to screen blood products, not to diagnose AIDS. The first-generation assays detected IgG antibody and became positive 6 to 12 weeks postinfection. False-positive results occurred; thus, a two-test algorithm was developed using a Western blot or immunofluorescence test as a confirmatory procedure. The second-generation HIV test added recombinant antigens, and the third-generation HIV tests included IgM detection, reducing the test-negative window to approximately 3 weeks postinfection. Fourth- and fifth-generation HIV assays added p24 antigen detection to the screening assay, reducing the test-negative window to 11 to 14 days. A new algorithm addressed the fourth-generation assay's ability to detect both antibody and antigen and yet not differentiate between them. The fifth-generation HIV assay provides separate antigen and antibody results and will require yet another algorithm. HIV infection may now be detected approximately 2 weeks postexposure, with a reduced number of false-positive results.

Diagnostic Tests; HIV Infections/*diagnosis; HIV/immunology/isolation & purification; Humans; Immunoassay/*methods/trends; Routine/*methods/trends

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