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Please explain the difference between 1st, 2nd, 3rd and 4th generation HIV tests?

Wednesday, 17 November 2004
Answered by: Dr. L.M. Nath
Consultant, Community Medicine,

New Delhi
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Q. Could you please explain the difference between 1st, 2nd, 3rd and 4th generation HIV tests?What would an HIV test utilising recombinant antigens be: 1st, 2nd, 3rd or 4th generation? Also, what is an Abbott Axsym test?

A.  ELISA, the most commonly performed diagnostic test in developing countries like India, to detect HIV Antibodies (Ab) is classified on the basis of Antigens (Ag) used. 1st Generation - used infected viral cell lysate as antigen. 2nd Generation - used glycopeptides (recombinant antigens) 3rd Generation - synthetic peptides are used as antigens. 4th Generation, are the newer tests for simultaneous detection of p24 Ag (HIV-1 Ag) and HIV-1/HIV-2Ab. HIV tests utilizing Recombinant antigens would be 2nd Generation. Abbot AxSYM test is a 3rd Generation test.

A.  ELISA, the most commonly performed diagnostic test in developing countries like India, to detect HIV Antibodies (Ab) is classified on the basis of Antigens (Ag) used. 1st Generation - used infected viral cell lysate as antigen. 2nd Generation - used glycopeptides (recombinant antigens) 3rd Generation - synthetic peptides are used as antigens. 4th Generation, are the newer tests for simultaneous detection of p24 Ag (HIV-1 Ag) and HIV-1/HIV-2Ab. HIV tests utilizing Recombinant antigens would be 2nd Generation. Abbot AxSYM test is a 3rd Generation test.

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