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Heterophile antibodies can arise in non-EBV infections. False positive monospot tests may occur in cases of HIV, lymphoma, or systemic lupus erythematosus. Other assays for detection of EBV are available, including serologic markers. [7] An important clinical pearl for heterophile antibodies is they can also be seen in genetic immunodeficiencies.
The mononuclear spot test or monospot test, a form of the heterophile antibody test, [1] is a rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV). It is an improvement on the Paul–Bunnell test. [2] The test is specific for heterophile antibodies produced by the human immune system in response to EBV
HIV antibody tests are highly sensitive, meaning they react preferentially with HIV antibodies, but not all positive or inconclusive HIV ELISA tests mean the person is infected by HIV. Risk history, and clinical judgement should be included in the assessment, and a confirmation test (western blot) should be administered.
An example of helpful cross-reactivity is in heterophile antibody tests, which detect Epstein-Barr virus using antibodies with specificity for other antigens. Cross-reactivity is also a commonly evaluated parameter for the validation of immune and protein binding based assays such as ELISA and RIA .
The OraQuick ADVANCE Rapid HIV-1/2 Antibody Test is a single-use, qualitative immunoassay that can be purchased over-the-counter (OTC). This test kit contains a test swab that collects oral fluid containing antibodies for HIV-1 and HIV-2 from the user’s gums. The material is gathered and combined with buffered developer solution in a test tube.
A rapid antigen test quickly searches for antigens, protein fragments that are found on the surface of or within a virus. Antigen tests can be analyzed within a few minutes. Antigen tests are less accurate than PCR tests. It has a low false positive rate, but a higher false negative rate.
HIV antibody tests exceed the performance of most other infectious disease tests in both sensitivity (the ability of the screening test to give a positive finding when the person tested truly has the disease) and specificity (the ability of the test to give a negative finding when the subjects tested are free of the disease under study).
Antibody levels against the virus during acute infection are often too low to be detected, meaning that an antibody test for a highly infectious individual can come back negative. [citation needed] There is at least one documented case of an HIV-positive individual with an undetectable viral load infecting his partner. [17]
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