ArticleRetrovirology2013
A novel acute HIV infection staging system based on 4th generation immunoassay.
Article in Retrovirology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
66 citing papers in PubMed, 2 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Acute and early HIV infection screening among men who have sex with men, a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review.AIDS (London, England) · 2015Pooled it
- Paradoxically Greater Persistence of HIV RNA-Positive Cells in Lymphoid Tissue When ART Is Initiated in the Earliest Stage of Infection.The Journal of infectious diseases · 2022Trial
- Anti-HIV antibody development up to 1 year after antiretroviral therapy initiation in acute HIV infection.The Journal of clinical investigation · 2022Trial
- Plasmacytoid dendritic cells sense HIV replication before detectable viremia following treatment interruption.The Journal of clinical investigation · 2020Trial
- Normalization of Soluble CD163 Levels After Institution of Antiretroviral Therapy During Acute HIV Infection Tracks with Fewer Neurological Abnormalities.The Journal of infectious diseases · 2018Trial
- Neurological Response to cART vs. cART plus Integrase Inhibitor and CCR5 Antagonist Initiated during Acute HIV.PloS one · 2015Trial
- Anogenital HIV RNA in Thai men who have sex with men in Bangkok during acute HIV infection and after randomization to standard vs. intensified antiretroviral regimens.Journal of the International AIDS Society · 2015Trial
- High HIV Incidence Among HIV-Infected But Undetected Individuals Seeking HIV Voluntary Counselling and Testing Services in the Greater Masaka Region in Uganda.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- A psychometric assessment of the Patient Health Questionnaire-9 for people living with acutely-treated HIV in Thailand.Psychiatry research communications · 2026Article
- HIV serologic reactivity varies with time of ART initiation in persons on long-term ART.Journal of clinical microbiology · 2026Article
- Viral load measurements and viral suppression in a cohort of acutely treated people living with HIV during the COVID-19 pandemic in Bangkok, Thailand: a longitudinal cohort analysis.BMJ public health · 2026Article
- Current insight into HIV-1 persistence from single-cell transcriptome profiling in acutely treated cohorts of infection.Current opinion in HIV and AIDS · 2025Review
- Dynamic changes in immune cell subsets in blood and lymph node over the course of acute HIV infection.Journal of virus eradication · 2025Article
- Single-cell analyses identify monocyte gene expression profiles that influence HIV-1 reservoir size in acutely treated cohorts.Nature communications · 2025Article
- Activation of CXCR3Journal of virology · 2025Article
- Acute HIV-1 Infection: Paradigm and Singularity.Viruses · 2025Review
- Mosaic vaccine-induced antibody-dependent cellular phagocytosis associated with delayed HIV-1 viral load rebound post treatment interruption.Cell reports · 2024Article
- Leveraging Donor Populations to Study the Epidemiology and Pathogenesis of Transfusion-Transmitted and Emerging Infectious Diseases.Transfusion medicine reviews · 2023Article
- An active HIV reservoir during ART is associated with maintenance of HIV-specific CD8Cell host & microbe · 2023Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundFourth generation (4thG) immunoassay (IA) is becoming the standard HIV screening method but was not available when the Fiebig acute HIV infection (AHI) staging system was proposed. Here we evaluated AHI staging based on a 4thG IA (4thG staging).
findingsScreening for AHI was performed in real-time by pooled nucleic acid testing (NAT, n=48,828 samples) and sequential enzyme immunoassay (EIA, n=3,939 samples) identifying 63 subjects with non-reactive 2nd generation EIA (Fiebig stages I (n=25), II (n=7), III (n=29), IV (n=2)). The majority of samples tested (n=53) were subtype CRF_01AE (77%). NAT+ subjects were re-staged into three 4thG stages: stage 1 (n=20; 4th gen EIA-, 3rd gen EIA-), stage 2 (n=12; 4th gen EIA+, 3rd gen EIA-), stage 3 (n=31; 4th gen EIA+, 3rd gen EIA+, Western blot-/indeterminate). 4thG staging distinguishes groups of AHI subjects by time since presumed HIV exposure, pattern of CD8+ T, B and natural killer cell absolute numbers, and HIV RNA and DNA levels. This staging system further stratified Fiebig I subjects: 18 subjects in 4thG stage 1 had lower HIV RNA and DNA levels than 7 subjects in 4thG stage 2.
conclusionsUsing 4th generation IA as part of AHI staging distinguishes groups of patients by time since exposure to HIV, lymphocyte numbers and HIV viral burden. It identifies two groups of Fiebig stage I subjects who display different levels of HIV RNA and DNA, which may have implication for HIV cure. 4th generation IA should be incorporated into AHI staging systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.