Fourth-generation HIV testing combines HIV-1 and HIV-2 antibody detection with HIV-1 p24 antigen detection in a single test. The p24 antigen appears earlier than antibodies — often within 2-4 weeks of infection — allowing earlier diagnosis. The combined test also detects the rare HIV-1 group O.
This test is recommended for routine HIV screening in adults, evaluation of suspected exposures, screening during pregnancy, and assessment of patients with HIV-related symptoms. Positive results trigger confirmatory testing to distinguish HIV-1 from HIV-2 and rule out false positives. With effective antiretroviral therapy available, early diagnosis is critical. Sample type is serum or plasma.