Detecting Acute Human Immunodeficiency Virus Infection Using 3 Different Screening Immunoassays and Nucleic Acid Amplification Testing for Human Immunodeficiency Virus RNA, 2006-2008

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Abstract
Acute human immunodeficiency virus (HIV) infection (AHI) represents the stage of the disease in which viral replication and shedding occurs before detectable antibody appears.1 During this time, viral load peaks in blood and genital secretions,2-5 resulting in individuals who are highly infectious and are often unaware of their HIV status.6 Individuals with AHI may have recently engaged in high-risk behaviors and have concurrent relationships.7-16 Several models have suggested that a disproportionate number—up to 50%—of new HIV infections are acquired by onward transmission from persons with AHI.16-21 Because most HIV-infected persons take measures to reduce their risk of further transmission after they learn of their infection,22-25identifying individuals during AHI affords an important opportunity for HIV prevention. Nonetheless, diagnosis of AHI is challenging and requires modification of standard HIV testing algorithms.