{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:15:10Z","timestamp":1788992110384,"version":"build-2803163510"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92019D00033"],"award-info":[{"award-number":["75N92019D00033"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH-18-2-0040"],"award-info":[{"award-number":["W81XWH-18-2-0040"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>HIV serologic responses measured by clinical screening assays may be blunted when antiretroviral treatment (ART) suppresses HIV replication from the initial infection stages, with further decay following long-term treatment. Sensitivity may vary according to the timing of ART initiation after HIV acquisition, antigens (Ags) utilized to detect anti-HIV antibodies (Abs), and HIV subtype. We obtained samples from long-term ART-suppressed persons with HIV (PWH) who started ART at acute\/early or during chronic infection, from blood donors with undetectable HIV RNA and nonreactive serology, and from blood donors with positive RNA and reactive serology (presumably untreated infections) spanning multiple HIV subtypes to compare patterns of serologic reactivity using two Ag\/Ab screening assays (Alinity and VITROS). We found that earlier ART initiation was associated with progressively lower signal-to-cutoff ratios (S\/CO) in both assays. Serologic reactivity in clinical samples from participants initiating ART at Fiebig 2 was somewhat lower for CRF01_AE (67%) than other HIV subtypes (91%) on the Alinity platform. In the late-ART initiation group, reactivity was high for both assays despite long-term treatment, with higher S\/CO values in samples from blood donors with presumably untreated infection. We observed no strong evidence of S\/CO waning &gt;96 weeks after ART initiation in the early-ART initiation group. Our findings suggest potential limitations for HIV infection ascertainment in clinical samples from long-term treated PWH who started ART at early infection stages using currently approved serologic tests.<\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>This manuscript increases our understanding of how the timing of initiation of HIV treatment affects our ability to detect the infection using commercial blood tests that measure HIV antigens or antibodies. Being able to detect HIV is important for clinical diagnostics and blood screening, and HIV is not as easily detected in persons who begin therapy shortly after infection using serological tests. In contrast to prior work, we show that current clinical HIV tests have stable reactivity over time in persons on long-term HIV treatment.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01273-25","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T17:59:57Z","timestamp":1765994397000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["HIV serologic reactivity varies with time of ART initiation in persons on long-term ART"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-3088","authenticated-orcid":true,"given":"Vivian I.","family":"Avelino-Silva","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Epidemiology and Biostatistics, University of California San Francisco","place":["San Francisco, USA"]},{"name":"Faculdade de Medicina da Universidade de Sao Paulo","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mars","family":"Stone","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6047-211X","authenticated-orcid":true,"given":"Clara","family":"Di Germanio","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion C.","family":"Lanteri","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]},{"name":"Creative Testing Solutions","place":["Tempe, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bakkour","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7046-7245","authenticated-orcid":true,"given":"Eduard","family":"Grebe","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Custer","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xutao","family":"Deng","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Pillai","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Buccheri","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven H.","family":"Kleinman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rmrcq20","id-type":"ROR","asserted-by":"publisher"}],"name":"University of British Columbia","place":["Victoria, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya","family":"Vasan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0145znz58","id-type":"ROR","asserted-by":"publisher"}],"name":"U.S. Military HIV Research Program, Walter Reed Army Institute of Research","place":["Silver Spring, USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3650-8490","authenticated-orcid":true,"given":"Morgane","family":"Rolland","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0145znz58","id-type":"ROR","asserted-by":"publisher"}],"name":"U.S. Military HIV Research Program, Walter Reed Army Institute of Research","place":["Silver Spring, USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nqadf13","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of HIV Research and Innovation (IHRI)","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Sacdalan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01z91qx97","id-type":"ROR","asserted-by":"publisher"}],"name":"SEARCH Research Foundation","place":["Bangkok, Thailand"]},{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Research Affairs, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siriwat","family":"Akapirat","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/023swxh49","id-type":"ROR","asserted-by":"publisher"}],"name":"Armed Forces Research Institute of Medical Sciences (AFRIMS)","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"de Souza","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nqadf13","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of HIV Research and Innovation (IHRI)","place":["Bangkok, Thailand"]},{"id":[{"id":"https:\/\/ror.org\/01z91qx97","id-type":"ROR","asserted-by":"publisher"}],"name":"SEARCH Research Foundation","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esper G.","family":"Kallas","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Sao Paulo","place":["S\u00e3o Paulo, Brazil"]},{"id":[{"id":"https:\/\/ror.org\/01whwkf30","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Butantan","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila de Oliveira Garcia","family":"Mateos","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Sao Paulo","place":["S\u00e3o Paulo, Brazil"]},{"id":[{"id":"https:\/\/ror.org\/00gby0d64","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Municipal de Sao Caetano do Sul","place":["S\u00e3o Caetano do Sul, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester C.","family":"Sabino","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Sao Paulo","place":["S\u00e3o Paulo, Brazil"]},{"id":[{"id":"https:\/\/ror.org\/00gby0d64","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Municipal de Sao Caetano do Sul","place":["S\u00e3o Caetano do Sul, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Busch","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0526-2088","authenticated-orcid":true,"given":"Philip J.","family":"Norris","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00r2ye360","id-type":"ROR","asserted-by":"publisher"}],"name":"Vitalant Research Institute","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Laboratory Medicine, University of California San Francisco","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, University of California San Francisco","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the NHLBI Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16931"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.35"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz145"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.107222"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001577"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab152"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab576"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.844023"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/428127"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2006.22.640"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix225"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002080"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2017.05.005"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.9.3122-3128.2001"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02045-17"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25204"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200309050-00005"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4690-10-56"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.18168"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2015.02.015"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-018-0026-6"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1008179"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu666"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy753"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1007976"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1086\/527416"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1086\/598502"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-03820-8"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.06.048"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-01858-2"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015738"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.01635-22"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.03070-12"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25032"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.5935\/1676-2444.20140026"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006890"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01273-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01273-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:01:08Z","timestamp":1768399268000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01273-25"}},"subtitle":[],"editor":[{"given":"Randall","family":"Hayden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,14]]}},"alternative-id":["10.1128\/jcm.01273-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01273-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]},"assertion":[{"value":"2025-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01273-25"}}