The characteristics of screening and confirmatory test results for HIV in Xi’an, China

Objectives: Individuals with recent or acute HIV infection are more infectious than those with established infection. Our objective was to analyze the characteristics of detection among HIV infections in Xi’an. Methods: A 4^th-generation kit (Architect HIV Ag/Ab Combo) and three 3^rd-generationEIA kits (WanTai, XinChuang and Livzon) were used for HIV screening. Overall, 665 individuals were identified as positive and were tested by western blotting (WB). The characteristics of the screening and confirmatory tests were analyzed, including the band patterns, the early detection performance and the false-positive rates. Results: In total, 561 of the 665 patients were confirmed as having HIV-1 infection, and no HIV-2 specific band was observed. Among these 561 WB-positive cases, reactivity to greater than or equal to 9 antigens was the most commonly observed pattern (83.18%), and the absence of reactivity to p17, p31 and gp41 was detected in 6.44%, 5.9% and 2.86% of the cases, respectively. Two cases were positive by the 4^th-generation assay but negative by the 3^rd-generation assay for HIV screening and had seroconversion. The false-positive rate of the Architect HIV Ag/Ab Combo (22.01%) was significantly higher than those of WanTai (9.88%), XinChuang (10.87%) and Livzon (8.93%), p<0.05. Conclusion: HIV infection in Xi’an is mainly caused by HIV-1, and individuals are rarely identified at the early phase. Although the false-positive rate of the 4^th-generation assay was higher than that of the 3^rd-generation assay, it is still recommended for use as the initial HIV screening test for high-risk individuals. In Xi’an, a 3rd-generation assay for screening could be considered.