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Abstract
Inability to recognize incident infection has traditionally limited both scientific and public health approaches to HIV disease. Recently, some laboratories have begun adding HIV nucleic acid amplification testing to HIV diagnostic testing algorithms so that acute (antibody-negative) HIV infections can be routinely detected within the first 1–3 weeks of exposure. In this review article, we will highlight critical opportunities for HIV treatment and prevention that are presented by these diagnostic strategies.
Authors
Christopher D. Pilcher, Joseph J. Eron Jr., Shannon Galvin, Cynthia Gay, Myron S. Cohen
Figure 1
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Acute HIV diagnostic timeline. Symptoms, when present, typically occur around 2 weeks after infection. Viremia is detectable prior to symptoms in the form of HIV p24 antigen (detectable by ELISA) or HIV RNA (detectable by even more sensitive nucleic acid amplification). While viremia reaches extremely high levels in the month or two following infection, p24 antigen typically becomes undetectable shortly before seroconversion, because of the formation of early antibody-antigen complexes. A secondary antibody-negative, p24 antigen–negative period is sometimes observed.
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ISSN: 0021-9738 (print), 1558-8238 (online)