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Scietific Abstarct on Winodw Period/Test Methods
      #5889 - 06/19/00 06:56 PM

(AIDSLINE) Consistent sequential detection of RNA, antigen and antibody in early HIV infection: assessment of the window period.
Int Conf AIDS. 1996 Jul 7-12;11(1):219 (abstract no. Tu.A.153). Unique Identifier : AIDSLINE MED/96921980
Busch M; Schumacher RT; Stramer S; Garrett PE; Boston Biomedica, Inc., Bridgewater, MA, USA. Fax: 508-580-0250.

Abstract: Objectives: To evaluate the evolution of significant markers of early HIV infection and assess their potential for reducing the HIV window period. Methods: Between 1987 and 1995, serial bleeds collected from individuals recently infected with HIV seroconversion, SC) were tested with methods designed to detect HIV antibody (@-HIV), antigen (HIV Ag), and RNA. Stability of frozen SC samples allowed the comparison over 8 years of detection with early @-HIV methods, so-called 3rd generation @-HIV methods, HIV Ag tests, and recently developed target amplification test methods for HIV RNA, and the concomitant reduction in time from infection with HIV to first marker detection (window period, WP). Results: In 1987, the WP for @-HIV was estimated at 42 days, based on tests of transfusion-infected individuals, surveillance programs of high-risk cohorts, and retrospectively recognized seroconverters from plasmapheresis programs. In 1995, a study of 31 SCs with currently available @-HIV tests (7 methods), HIV Ag tests (5 methods), and newly available HIV RNA tests (3 methods) indicated that the WP for the more sensitive @-HIV tests was reduced to 18.5 days, that screening for HIV Ag could produce a further reduction to 8 days, and that screening with HIV RNA tests could reduce the WP further still, to 5.3 days. Conclusions: 1) Seroconversions consistently demonstrate the sequential appearance in blood of HIV RNA, HIV Ag, and @-HIV. 2) Detection of HIV RNA and/or HIV Ag can be used to confirm early infection. 3) RNA and/or HIV Ag tests are potentially useful for earlier detection of HIV infection (e.g., blood screening). 4) SCs provide a valuable benchmark for following the improvement in sensitivity of tests for early HIV infection.
Keywords: *Gene Amplification/METHODS *HIV/ISOLATION & PURIF *HIV Antibodies/BLOOD *HIV Antigens/BLOOD *HIV Seropositivity/VIROLOGY *Immunoassay/METHODS *RNA, Viral/BLOOD
SOURCE: National Library of Medicine. NOTICE: This material may be protected by Copyright Law (Title 17, U.S.Code).

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Re: Scietific Abstarct on Winodw Period/Test Methods new
      #5891 - 06/19/00 07:40 PM

WQhat does this mean, then? That the mean time for detection using an RNA PCR is like 5 days? That antibody tests now will detect around 18 days? That's good news on average.

I am increasingly thinking that a 3 month window will catch everyone except for a couple here and there. That we haven't seen the movement by the CDC yet because they want to be extra special sure, but I think the 6 month window is based on data from earlier in the epidemic. . . . i think it's getting outdated.

Does anyone have anythoughts?

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Re: Scietific Abstarct on Winodw Period/Test Methods new
      #5898 - 06/19/00 09:01 PM

Yup, that's pretty much what the abstract is saying. That newer HIV antibody tests (and PCR tests) are having a shortening effect on the window period. The 18 days is the mean (or is it the median - my math's a little rusty) date for showing sero-positivity in this particular study. Whether or not that's the actual number, I have no idea. But most sources say that the mean/median is about 25 days, so this kinda' corresponds to that.

Articles like these also reinforce my belief in the 3 month window.

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