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Evaluation of serological assays for the diagnosis of HIV infection in adults

Avania Bangalee, Sachin Bhoora, Rivak Punchoo
South African Family Practice | Vol 63, No 1 : Part 4| a5316 | DOI: https://doi.org/10.4102/safp.v63i1.5316 | © 2021 Avania Bangalee, Sachin Bhoora, Rivak Punchoo | This work is licensed under CC Attribution 4.0
Submitted: 09 April 2021 | Published: 25 October 2021

About the author(s)

Avania Bangalee, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, Tshwane Academic Division, National Health Laboratory Services, Tshwane, South Africa
Sachin Bhoora, Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Rivak Punchoo, Tshwane Academic Division, National Health Laboratory Services, Tshwane, South Africa; and, Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

Abstract

Serological tests based on the enzyme immunoassay (EIA) are the primary tool for the diagnosis of human immunodeficiency virus (HIV) in adults and have rapidly evolved to quicker, affordable and more accurate test formats to detect early HIV infection. Second- and third-generation HIV rapid tests detect the immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to the HIV and are used at the point of care and in HIV self-testing. The tests are affordable and accessible in state and private diagnostic laboratories. The present-day fourth- and fifth-generation EIAs can detect both p24 antigen and IgG and IgM HIV antibodies and thereby diagnose early HIV infection at approximately 2 weeks. The fourth- and fifth-generation EIAs also report sensitivity and specificity of more than 99%. The correct interpretation of HIV diagnosis of false-positive and false-negative EIA test results requires collaborative scrutiny of patient factors and laboratory test methodologies.

Keywords

human immunodeficiency virus; HIV; enzyme immunoassay; enzyme-linked immunosorbent assay; EIA; ELISA; analytical error, HIV biomarkers, HIV diagnosis

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