EUH Krakow Conference: What is the sensitivity of the 4th generation test for acute HIV infection?

The Bottom Line:  A study involving 86,836 participants found the Abbott Architect HIV Ag/Ab Combo Assay to have a 79.8% sensitivity and 99.9% specificity with a positive predictive value of 59% (Peters et al, 2016).

Reference: Peters PJ, Westheimer E, Cohen, S, et al. “Screening yield of HIV antigen/antibody combination and pooled HIV RNA testing for acute HIV infection in a high-prevalence population.” JAMA. 2016; 315(7):682-690. doi:10.1001/jama.2016.0286

Summary:  In a high-prevalence population, HIV screening using an HIV Ag/Ab combination assay following a negative rapid test detected 82% of acute HIV infections detectable by pooled HIV RNA testing, with a positive predictive value of 59%. It increased the absolute HIV diagnostic yield by 0.15% (a 10.4% increase in the relative diagnostic yield). Further research is needed to evaluate this strategy in lower-prevalence populations and in persons using preexposure prophylaxis for HIV prevention (Peters et al, 2016).

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