Detection of specific human immunodeficiency virus IgM antibodies

This study was done to demonstrate whether the use of the antigen-sandwich human immunodeficiency virus (HIV) antibody-screening assays (3rd generation assays), which detect all classes of anti-HIV immunoglobulins, leads to an earlier detection of HIV IgM compared to the 2nd generation HIV antibody-screening assays. We tested sequential bleeds of three donors obtained from commercially available seroconversion panels. Anti-HIV testing was done before and after high-performance liquid chromatography separation of IgG and IgM fractions. The positive result of the first bleedings from all three panels was linked to the IgM fraction, while at that time the IgG fraction was still negative. For subsequent samples drawn 5-9 days later, a positive signal was obtained with the IgG fraction in addition to a stronger positive signal obtained with the IgM fraction. We conclude that an assay capable of simultaneously detecting different immunoglobulin classes, including IgM, will help to narrow the "window period" for serological detection of seroconversion to HIV by detecting anti-HIV IgM-containing samples earlier than conventional assays using only anti-human IgG enzyme conjugates (indirect anti-HIV-screening assay, 2nd generation assays).