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Int J STD AIDS. 2015 Mar;26(4):215-24. doi: 10.1177/0956462414542987. Epub 2014 Jul 16.

Probability of a false-negative HIV antibody test result during the window period: a tool for pre- and post-test counselling.

Author information

1
British Columbia Centre for Disease Control, Vancouver, BC, Canada School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada Darlene.taylor@bccd.ca.
2
British Columbia Centre for Disease Control, Vancouver, BC, Canada.
3
Alberta Health Services, Edmonton, AB, Canada.
4
Public Health Agency of Canada, Ottawa, ON, Canada.
5
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
6
British Columbia Centre for Disease Control, Vancouver, BC, Canada School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
7
British Columbia Centre for Disease Control, Vancouver, BC, Canada BCCDC Public Health Microbiology and Reference Laboratory, Vancouver, BC, Canada.
8
British Columbia Centre for Disease Control, Vancouver, BC, Canada BCCDC Public Health Microbiology and Reference Laboratory, Vancouver, BC, Canada Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
9
British Columbia Centre for Disease Control, Vancouver, BC, Canada Family Practice, University of British Columiba, Vancouver, BC, Canada.

Abstract

Failure to understand the risk of false-negative HIV test results during the window period results in anxiety. Patients typically want accurate test results as soon as possible while clinicians prefer to wait until the probability of a false-negative is virtually nil. This review summarizes the median window periods for third-generation antibody and fourth-generation HIV tests and provides the probability of a false-negative result for various days post-exposure. Data were extracted from published seroconversion panels. A 10-day eclipse period was used to estimate days from infection to first detection of HIV RNA. Median (interquartile range) days to seroconversion were calculated and probabilities of a false-negative result at various time periods post-exposure are reported. The median (interquartile range) window period for third-generation tests was 22 days (19-25) and 18 days (16-24) for fourth-generation tests. The probability of a false-negative result is 0.01 at 80 days' post-exposure for third-generation tests and at 42 days for fourth-generation tests. The table of probabilities of falsely-negative HIV test results may be useful during pre- and post-test HIV counselling to inform co-decision making regarding the ideal time to test for HIV.

KEYWORDS:

AIDS; HIV; HIV assays; diagnosis; eclipse period; false-negative; seroconversion; testing; window period

PMID:
25033879
DOI:
10.1177/0956462414542987
[Indexed for MEDLINE]

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