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HIV
(yellow) infecting a human immune cell. Credit: Seth Pincus, Elizabeth
Fischer and Austin Athman, National Institute of Allergy and Infectious
Diseases, National Institutes of Health
In a study
appearing in the February 16 issue of JAMA, Philip J. Peters, M.D., of
the Centers for Disease Control and Prevention, Atlanta, and colleagues
evaluated the performance of an HIV antigen/antibody (Ag/Ab) combination
assay to detect acute HIV infection (early infection) compared with
pooled HIV RNA testing, the reference standard.
The study
included 86,836 participants in a high-prevalence population from 7
sexually transmitted infection clinics and 5 community-based programs in
New York, California, and North Carolina. Although acute HIV infection
contributes disproportionately to onward HIV transmission, HIV testing
has not routinely included screening for acute infection.
The
researchers found that the HIV Ag/Ab combination assay in place of rapid
HIV testing increased the absolute HIV diagnostic yield by 0.15 percent
and diagnosed 82 percent of the acute HIV infections detectable by
pooled RNA testing. Compared with rapid HIV testing alone, HIV Ag/Ab
combination testing increased the relative HIV diagnostic yield (both
established and acute HIV infections) by 10.4 percent and pooled HIV RNA
testing increased the relative HIV diagnostic yield by 12.4 percent.
"Alternative strategies such as using a laboratory-based HIV Ag/Ab
combination assay that can detect acute infection should be considered
in high-prevalence populations in the United States."
Source : Medical xpress
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