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  • Title: [Evaluation of various tests for the detection of antigen and antibodies in the diagnosis of primary HIV infection].
    Author: Soriano V, Tor J, Ribera A, Muga R, Rivas-Mundó M.
    Journal: Enferm Infecc Microbiol Clin; 1990; 8(7):434-7. PubMed ID: 2152480.
    Abstract:
    The effectiveness of different methodologies to identify antigenemia and antibodies against HIV at the time of viral primary infection was evaluated. To this end, 6 consecutive serum samples of a patient who had had symptomatic seroconversion were assessed. The detection of antigenemia was earlier than that of antibodies, although the sensitivity of the three evaluated assays varied greatly. An enzyme immunoassay (EIA) designed with synthetic peptides from the HIV envelope (third generation EIA) was the most sensitive test for antibody detection. Five other tests elaborated with antigenic material from a viral lysate (first generation) or with recombinant proteins (second generation) were reactive later, although the second generation EIA were more sensitive. A rapid immunofiltration test (HIV-Check) had good sensitivity, similar to that of the second generation EIA. Western blotting (WB) identified antibodies against the viral core later than the third generation EIA, and all the bands required for the diagnosis only appeared three weeks later. Therefore, although WB is an excellent method to confirm results from other tests, it may not be definitive for the results at the primary infection period when other particularly sensitive techniques are already diagnostic. We think that the higher sensitivity of EIA tests using synthetic peptides justifies its generalization for sample screening in blood banks.
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