CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1562946
This article is part of the Research TopicInfectious Diseases and Hematology: Diagnosis and Management - Volume IIView all 13 articles
High Sensitivity of HIV Antibody Screening Tests May Lead to Longer Time to Diagnosis： Case Report
Provisionally accepted
- Westchina hospital of Sichuan University, Chengdu, China
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Background: The fourth-generation HIV serology assay, which simultaneously detects HIV-1 P24 antigen and HIV-1 antibodies, is available in either a combined format or as dual tests that differentiate between the P24 antigen and antibodies. Divergent detection methodologies necessitate distinct confirmatory testing algorithms, which significantly impact the time-todiagnosis for HIV infection.Case presentation: In this report, we present three cases where the HIV-1 P24 antigen tested reactive while the HIV-1 antibody remained nonreactive in a dual testing scenario, despite both the combined test and the gold immunochromatographic assay (GICA) for HIV-1 antibodies returning reactive results. Upon further analysis of subsequent laboratory procedures, we observed that due to the application of various complementary testing, the assay with high antibody sensitivity like GICA has, in contrast, resulted in a prolonged time to diagnosis for patients from 5 days to 11 days. Conclusion: Our findings underscore the necessity of prioritizing HIV-1 RNA testing in cases of discordant results between combined antigen/antibody testing, dual testing, and stand-alone antibody testing, particularly for patients who have not undergone pre-exposure or postexposure prophylaxis.
Keywords: HIV serological assay, P24 antigen, antibody HIV, Diagnosis period, algorithm, Fourth generation assay
Received: 18 Jan 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Wang, Luo, Deng, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dongdong Li, Westchina hospital of Sichuan University, Chengdu, China
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