title: Prolonged second diagnostic window for human immunodeficiency virus type 1 in a fourth-generation immunoassay: are alternative testing strategies required?
abstract: Diagnosis of acute HIV is done by patient history and examination and testing of RNA, proviral DNA, and serology using fourth-generation antigen/antibody detection assays. We describe an HIV-1 primary infection with a second diagnostic window of 18 to 34 days on a fourth-generation immunoassay, which would have been missed using some current algorithms. Caution must be exercised when fourth-generation HIV-1 immunoassays are interpreted in isolation, and additional testing should be considered depending on patient risk assessment.
authors.affiliation: Department of Microbiology, SEALS Pathology, The Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: C R Robert
authors.initials: CR
authors.lastname: George
authors.affiliation: Department of Microbiology, SEALS Pathology, The Prince of Wales Hospital, Randwick, New South Wales, Australia School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Robertson
authors.affiliation: School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia Short Street Centre, St George Hospital, Kogarah, New South Wales, Australia.
authors.forename: M Josephine
authors.initials: MJ
authors.lastname: Lusk
authors.affiliation: Department of Microbiology, SEALS Pathology, The Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Whybin
authors.affiliation: Department of Microbiology, SEALS Pathology, The Prince of Wales Hospital, Randwick, New South Wales, Australia School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington New South Wales, Australia w.rawlinson@unsw.edu.au.
authors.forename: William
authors.initials: W
authors.lastname: Rawlinson
mesh_terms: D000328:Adult; D003955:Diagnostic Tests, Routine / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D013997:Time Factors