Time course of detection of viral and serologic markers preceding human immunodeficiency virus type 1 seroconversion: implications for screening of blood and tissue donors

Abstract

Recent improvement in the sensitivity of anti-HIV assays has resulted in significant shortening of the preseroconversion window period. Consequently, the incremental reduction in the window period that could be achieved by implementing direct virus-detection assays has diminished significantly.

Misdiagnosis of HIV Infection by HIV-1 Plasma Viral Load Testing: A Case Series

“…The combination of screening ELISA followed by a confirmatory Western blot assay has been more than 99% accurate in detecting HIV infection (10,11). This protocol has a relatively low rate of false-positive results (approximately 0.0006%) but can have negative or indeterminate results during the 3 to 4 weeks before seroconversion (12)(13)(14). Although host antibody responses may be undetectable during this acute infection period, the viral load in plasma is usually very high and initial viremia usually occurs in 4 to 11 days (4,7,15,16).…”

Risk of virus transmission through femoral head allografts: A Belgian appraisal

“…The sensitivity of antibody assay has largely increased with the availability of third-generation assays with a subsequent narrowing of the window period for HIV from 42 to 22 days. 20,21 The use of either amplification tests such as HIV-DNA polymerase chain reaction or HIV p24 antigen testing will further decrease the window from 22 to 16 days. 21 PCR can be performed on bone marrow, a good reservoir of lymphocytes presenting the advantage of being easily accessible and less sensitive to hemorrhage in the case of depleted or haemodiluted blood volume.…”

“…20,21 The use of either amplification tests such as HIV-DNA polymerase chain reaction or HIV p24 antigen testing will further decrease the window from 22 to 16 days. 21 PCR can be performed on bone marrow, a good reservoir of lymphocytes presenting the advantage of being easily accessible and less sensitive to hemorrhage in the case of depleted or haemodiluted blood volume. 22 The same holds true for HCV for which a secondgeneration of antibody detection in 1992 could detect two reactive cases amongst 470 negative sera from previously negatively tested donors with the first-generation anti-HCV assay.…”

Acute Human Immunodeficiency Virus Syndrome in an Adolescent

“…Both falsepositive and false-negative results for these assays have been reported, further complicating early diagnosis. [7][8][9] Pediatricians should play an active role in identifying HIV-infected patients. Both the American Academy of Pediatrics and the Centers for Disease Control and Prevention encourage HIV testing for those at risk, such as sexually active adolescents.…”