Detection of Acute Infections during HIV Testing in North Carolina

Standard antibody screening does not detect recent infection in persons who have viremia but are antibody-negative. In North Carolina, nucleic acid amplification testing for HIV was added to the screening of 109,250 subjects who were tested during one year. A total of 23 acutely infected subjects were identified only with the use of this additional test. In North Carolina, nucleic acid amplification testing for HIV was added to the screening of 109,250 subjects who were tested during one year. A total of 23 acutely infected subjects were identified only with the use of this additional test. Acute infection with the human immunodeficiency virus (HIV) is rarely recognized. It is associated with a high probability of secondary HIV transmission, 1 – 5 probably because of the magnitude of viremia and genital shedding of virus. Since routine HIV antibody tests yield negative results during the first four to five weeks of HIV infection, 6 acute infections can be diagnosed during this period only with the use of tests for viral antigens, nucleic acids, or both. Sensitive nucleic acid amplification tests are routinely used by blood banks to protect the blood supply. 7 However, concerns about cost and specificity have precluded the use . . .