Article Text

Download PDFPDF
Low rates of p24 antigen detection using a fourth-generation point of care HIV test
  1. Julie Fox1,
  2. Helen Dunn2,
  3. Siobhan O'Shea2
  1. 1Department of Genito-Urinary Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2Infection and Immunology, Virology Section, GSTS Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Julie Fox, Department of HIV, Faculty of Medicine, Guys and St Thomas' NHS Trust/Kings College London, London, UK;{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


Over one-quarter of people living with HIV infection in the UK are unaware of their HIV infection.1 HIV point-of-care testing (POCT) can greatly improve the uptake and acceptability of HIV testing across hospital and community settings2 3 and, until now, has been carried out using a third-generation antibody assay. As such, cases of suspected PHI are referred for fourth-generation combination testing.

Identification of PHI is important, as identification during this hyperinfectiousness period may reduce onward HIV transmission events,4–6 and early intervention with antiretroviral therapy may enhance the long-term clinical outcome.7–10

A significant advance in HIV POCT has been the development of the Determine HIV-1/2 Ag/Ab Combo assay (Inverness Medical, now renamed Alere). This is the first rapid fourth-generation assay for simultaneous detection of HIV p24 antigen and antibodies to HIV-1 and HIV-2. However, this assay has been introduced into routine care in …

View Full Text


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.