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The eclipse period is a variable period starting from HIV exposure in which no existing test can detect HIV. The median duration of the eclipse period in one study was 11.5 days. The window period is the time between HIV exposure and when an antibody or antigen test can detect HIV. The median window period for antibody/antigen testing is 18 days.
The window period for HIV may be up to three months, depending on the test method and other factors. RNA based HIV tests has the lowest window period. Modern and accurate testing abilities can cut this period to 25 days, 16 days, or even as low as 12 days, again, depending on the type of test and the quality of its administration and interpretation.
A negative test result does not confirm individuals are not infected by HIV. There is a window period of approximately 3 months when individuals are still not producing enough antibodies to generate a positive result, thus it is recommended to test regularly. [14] False positives. Lyme disease, syphilis, lupus, and other conditions can ...
Modern HIV testing is extremely accurate, when the window period is taken into consideration. A single screening test is correct more than 99% of the time. [ 119 ] The chance of a false-positive result in a standard two-step testing protocol is estimated to be about 1 in 250,000 in a low risk population. [ 120 ]
A non-reactive (negative) rapid point of care test should still be followed up with immunoassay testing such as by a fourth-generation test after the window period. [27] Similarly, individuals taking pre-exposure prophylaxis (PrEP) can experience extended window periods compared to the average population, leading to ambiguous testing. [ 28 ]
The standard test for HIV is an enzyme immunoassay test that reacts with antibodies to the virus. This test has a window period where a person will be infected but not yet have an immune response. Other tests are used to look for donors during this period, specifically the p24 antigen test and nucleic acid testing.
While most patients with HIV show an antibody response after six weeks, window periods vary and may occasionally be as long as three months. [14] Progress in testing methodology has enabled detection of viral genetic material, antigens, and the virus itself in bodily fluids and cells.
Pooled viral RNA testing shortens the window period to a median of 17 days (95% CI, 13-28 Days). [9] Although it is not the standard of care to use this test for diagnosis, in communities with high HIV prevalence, this test has a significantly improved negative predictive value over 3rd and 4th generation tests for detecting acute HIV infections.
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