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The hemagglutination assay or haemagglutination assay (HA) and the hemagglutination inhibition assay (HI or HAI) were developed in 1941–42 by American virologist George Hirst as methods for quantifying the relative concentration of viruses, bacteria, or antibodies.
Hemagglutination, or haemagglutination, is a specific form of agglutination that involves red blood cells (RBCs). It has two common uses in the laboratory: blood typing and the quantification of virus dilutions in a haemagglutination assay .
Consequently, those viruses bound to antibodies are unable to link RBCs, meaning that a test’s positive result due to hemagglutination has been inhibited. On the contrary, if hemagglutination occurs, the test will result negative. A schematic diagram of the experimental setup to detect hemagglutination for blood typing.
The assay produces a result of hemagglutination units (HAU), with typical PFU to HAU ratios in the 10 6 range. [12] [13] [14] This assay takes ~1–2 hours to complete. The hemagglutination inhibition assay is a common variation of the HA assay used to measure flu-specific antibody levels in blood serum.
Immunologic pregnancy tests were introduced in 1960 when Wide and Gemzell presented a test based on in-vitro hemagglutination inhibition. This was a first step away from in-vivo pregnancy testing [ 42 ] [ 43 ] and initiated a series of improvements in pregnancy testing leading to the contemporary at-home testing. [ 43 ]
In the past nucleic acid tests have mainly been used as a secondary test to confirm positive serological results. [3] However, as they become cheaper and more automated, they are increasingly becoming the primary tool for diagnostics and can also be use for monitoring of treatment of viral infected individuals t.
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[2] [3] [15] This hemagglutination inhibition assay (HIA) can be applied to many other viruses carrying a hemagglutinin molecule, including rubella, measles, mumps, parainfluenza, adenoviruses, polyomaviruses and arboviruses, and is still widely used in influenza surveillance and vaccine testing.