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4th generation tests

Oct 6, 2004

Hello Dr.Bob.

I am the guy from Izmir, Turkey.

I have asked this question before but you havent answered, so i am gonna try one more :)

This is not a ' a transexual midget's nipple got in my eye' quesiton :)

Just simple: -What's your opinion about 4th generation tests? They say that 3 weeks is enough with combination of p24+anti-HIV

VIDAS DUO is one of them... (

Should we relay on this tests? Is it a revolution?

I love you Dr.Bob. May the Allah be with you.

With my all Love...

Response from Dr. Frascino

Hi Izmir-Guy,

Revolution? No, it's much more evolution. HIV-testing technology continues to gradually improve. Second generation tests are generally better than first generation tests; third generation, better than second; and fourth, better than third. I'm also quite certain that fifth generation tests (when they are developed) will be more sophisticated than fourth generation tests. However, just the "generation" number isn't enough to assure the test is really better. For instance, a well-studied, reliable 2nd or 3rd generation FDA-approved ELISA test may be a much better test than an FDA-unapproved test, even if the unapproved test uses 4th generation technology. As for adding a P-24 assay to the test, many experts (myself included) do not recommend P-24 antigen testing (or PCR testing either) for routine screening. As to sensitivity and specificity issues, the PCR technology is superior to P-24 antigen technology, and also significantly more expensive.

Finally Izmir-Guy, please note the advice I give here is global. Not everyone has access to 4th generation tests, PCRs or P-24s. Consequently, until additional large epidemiological studies are done, my advice and the testing guidelines remain the unchanged. HIV antibody testing is recommended for routine screening. HIV antibody tests can be considered conclusive at three months (or longer) for most exposures.

Stay well and let's hope Allah, God, Buddha, and all the higher powers can bring peace and health to our troubled world.

Dr. Bob


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