BACKGROUND: Despite the improved sensitivity of the 4th generation combined antigen/antibody HIV assays, detection of HIV in the early phase of an infection may still be ineffective. OBJECTIVES: Description of two cases that highlight the existence of the "second diagnostic window phase" observed with commonly used sensitive 4th generation HIV assays. STUDY DESIGN: Samples were screened with different 4th generation HIV assays. HIV infection was confirmed with an HIV I/II antibody assay, a HIV-1 p24 antigen assay, the INNO-LIA HIV I/II Score Line immunoassay and HIV-1 PCR. RESULTS: In both investigated cases, the limitations of the 4th generation HIV assays within the second diagnostic window were apparent. CONCLUSIONS: The overall sensitivity of the commercial 4th generation HIV assays is currently higher than the 3rd generation HIV assays. Nevertheless, the rare occurrence of a second diagnostic window with 4th generation HIV assays strongly suggests that the following up testing algorithms need to be adjusted accordingly.
BACKGROUND: Despite the improved sensitivity of the 4th generation combined antigen/antibody HIV assays, detection of HIV in the early phase of an infection may still be ineffective. OBJECTIVES: Description of two cases that highlight the existence of the "second diagnostic window phase" observed with commonly used sensitive 4th generation HIV assays. STUDY DESIGN: Samples were screened with different 4th generation HIV assays. HIV infection was confirmed with an HIV I/II antibody assay, a HIV-1 p24 antigen assay, the INNO-LIA HIV I/II Score Line immunoassay and HIV-1 PCR. RESULTS: In both investigated cases, the limitations of the 4th generation HIV assays within the second diagnostic window were apparent. CONCLUSIONS: The overall sensitivity of the commercial 4th generation HIV assays is currently higher than the 3rd generation HIV assays. Nevertheless, the rare occurrence of a second diagnostic window with 4th generation HIV assays strongly suggests that the following up testing algorithms need to be adjusted accordingly.
Authors: Sheldon R Morris; Susan J Little; Terry Cunningham; Richard S Garfein; Douglas D Richman; Davey M Smith Journal: Ann Intern Med Date: 2010-06-15 Impact factor: 25.391
Authors: C R Robert George; Peter W Robertson; M Josephine Lusk; Ross Whybin; William Rawlinson Journal: J Clin Microbiol Date: 2014-09-10 Impact factor: 5.948
Authors: A Mühlbacher; H Schennach; J van Helden; T Hebell; G Pantaleo; P Bürgisser; C Cellerai; P Permpikul; M I Rodriguez; A Eiras; F Alborino; P Cunningham; M Axelsson; S Andersson; O Wetlitzky; C Kaiser; P Möller; G de Sousa Journal: Med Microbiol Immunol Date: 2012-06-17 Impact factor: 3.402