Related Experiment Video
Updated: Jul 30, 2026
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
Optimizing HIV testing: Comparing diagnostic signatures and assay performance in ART-treated and general screening
Qian Liu1, Xinru Liu2, Le Chang2
1Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Insights
Accurate HIV detection is vital for patient outcomes and transmission control. This study reveals distinct HIV marker patterns in ART-treated individuals versus general screening, necessitating tailored diagnostic approaches for blood safety.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Early and accurate Human Immunodeficiency Virus (HIV) detection is critical for patient management and preventing transmission.
- Understanding HIV marker patterns in different populations, including those on Antiretroviral Therapy (ART), is essential for refining diagnostic strategies.
Purpose of the Study:
- To compare HIV marker profiles between individuals on ART and those undergoing general blood screening.
- To evaluate the performance of various HIV detection assays in these distinct populations.
- To enhance the accuracy of HIV diagnostics and improve blood transfusion safety.
Main Methods:
- Analysis of 196 blood donor samples and 126 samples from people living with HIV (PLWH) on ART.
- Detection assays included HIV RNA (NAT), antigen/antibody (Ag/Ab) combination assays, and Western blot (WB).
- Evaluation of the performance of two antigen detection kits and eight Ag/Ab kits.
Main Results:
- All ART samples were Ag/Ab positive; 32.5% had undetectable viral loads.
- Blood donors showed 90.8% positivity for both NAT and Ag/Ab, with a subset indicating early acute infection (NAT-positive, Ag/Ab-negative).
- Fourth-generation Ag/Ab kits demonstrated high sensitivity (95.2%) for NAT-positive donors, with the Roche kit performing best.
Conclusions:
- Significant differences exist in HIV detection markers between ART-treated individuals and general screening populations.
- Current diagnostic assays show varying performance across these groups.
- Tailored diagnostic strategies are crucial for ensuring blood safety and effective HIV management.
Introduction:
Accurate and early HIV detection is crucial for improving outcomes and controlling transmission. This study compares HIV marker patterns and evaluates detection assay performance in general screening and ART-treated populations to enhance diagnostic accuracy and public health.
Methods:
A total of 196 blood donor samples that were initially reactive in blood center screening were collected across 17 provinces in China, along with 126 ART samples from people living with HIV (PLWH). HIV RNA, Ag/Ab, and western blot were conducted in both groups. CD4 T cell counts were assessed in PLWH. The performance of two antigen detection kits (Wantai, Livzon) and eight Ag/Ab kits (Roche, Abbott, KHB, InTec, Wantai, Livzon, Murex, Bio-rad) were evaluated.
Results:
In the ART group, all samples were Ag/Ab positive, with 32.5 % (41/126) having undetectable viral loads; NAT-positive samples showed a higher rate of complete bands in western blot compared to NAT-negative group (42.5 % vs 15.4 %, P = 0.021), while p17, p39, and p31 bands were often absent. 90.8 % (178/196) of blood donors were NAT-positive and Ag/Ab-positive. 4.6 % (9/196) of blood donors were NAT-positive but Ag/Ab-negative, these samples were also tested as NAT-only reactive in screening at blood centers, often showing only a p24 band or negative result in WB, indicating early acute infection. 3.6 % (7/196) of blood donors were confirmed as NAT-negative but Ag/Ab-positive, hinting that a small group on ART might attempt to donate blood. HIV serological kits showed 100 % positivity in the ART group. Fourth-generation kits, particularly the Roche Ag/Ab kit, showed the highest sensitivity (95.2 %) for NAT-positive donors.
Discussion:
This study highlights critical differences in HIV detection between ART-treated individuals and general screening populations, emphasizing the need for tailored diagnostic strategies to ensure blood transfusion safety.
Related Concept Videos
01:15Receiver Operating Characteristic Plot
01:24Automated Microbial Diagnostics