Abstract
ObjectivesIndividuals with recent or acute HIV infection are more infectious than those with established infection. Our objective was to analyze the characteristics of detection among HIV infections in Xi'an.MethodsA 4th-generation kit (Architect HIV Ag/Ab Combo) and three 3rd-generationEIA kits (WanTai, XinChuang and Livzon) were used for HIV screening. Overall, 665 individuals were identified as positive and were tested by western blotting (WB). The characteristics of the screening and confirmatory tests were analyzed, including the band patterns, the early detection performance and the false-positive rates.ResultsIn total, 561 of the 665 patients were confirmed as having HIV-1 infection, and no HIV-2 specific band was observed. Among these 561 WB-positive cases, reactivity to greater than or equal to 9 antigens was the most commonly observed pattern (83.18%), and the absence of reactivity to p17, p31 and gp41 was detected in 6.44%, 5.9% and 2.86% of the cases, respectively. Two cases were positive by the 4th-generation assay but negative by the 3rd-generation assay for HIV screening and had seroconversion. The false-positive rate of the Architect HIV Ag/Ab Combo (22.01%) was significantly higher than those of WanTai (9.88%), XinChuang (10.87%) and Livzon (8.93%), p<0.05.ConclusionHIV infection in Xi'an is mainly caused by HIV-1, and individuals are rarely identified at the early phase. Although the false-positive rate of the 4th-generation assay was higher than that of the 3rd-generation assay, it is still recommended for use as the initial HIV screening test for high-risk individuals. In Xi’an, a 3rd-generation assay for screening could be considered.
Highlights
Since the first case of AIDS was identified in 1981 in the USA [1], HIV has spread at an alarming rate around the world, with approximately 36.9 million people infected worldwide [2]
The false-positive rate of the Architect HIV Ag/Ab Combo (22.01%) was significantly higher than those of WanTai (9.88%), XinChuang (10.87%) and Livzon (8.93%), p
HIV infection in Xi’an is mainly caused by HIV-1, and individuals are rarely identified at the early phase
Summary
Since the first case of AIDS was identified in 1981 in the USA [1], HIV has spread at an alarming rate around the world, with approximately 36.9 million people infected worldwide [2]. Early screening tests for individuals in a high-risk setting are key to managing HIV infection. The 3rd-and 4th-generation tests are the preferred assays for HIV screening and diagnosis. The 3rd-generation assay can detect HIV-1/2 IgG/IgM antibodies within a window of approximately 3–4 weeks after exposure. The 4th-generation assay combines HIV-1/2 antibodies and p24 antigen detection with a window of approximately 2–3 weeks [6,7,8,9]. The p24 antigen is associated with acute HIV infection [9] and the 4th-generation assay has better sensitivity during early infection than the 3rd-generation assay [6,7,8,9,10,11,12,13], nonspecific reactions are often detected using the 4th-generation assay [14,15,16,17,18]. 665 patients were confirmed by WB at the Xi’an Center for Disease Control and Prevention (CDC), and we analyzed the characteristics of the screening test, the confirmatory test and the patients’ follow-up results
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