Laboratory diagnosis — screening for HIV infection: Which of the following assay types are used as screening tests for the detection of HIV infection prior to confirmatory testing?

Introduction / Context:
Screening tests for HIV must be sensitive, scalable, and suitable for high-throughput or point-of-care use. Positive screens are then confirmed by more specific methods.

Given Data / Assumptions:

• ELISA (including fourth-generation antigen/antibody tests) is a standard screening platform.
• Latex agglutination and dot blot/rapid assays have been used as preliminary screens in various settings.
• Confirmation requires a different, more specific method (e.g., differentiation immunoassay or nucleic acid test).

Concept / Approach:
The question focuses on screening, not confirmation. ELISAs and rapid immunoassays detect antibodies and/or p24 antigen with high sensitivity. Latex agglutination formats can serve as initial screens but are generally supplemented by confirmatory testing.

Step-by-Step Solution:
Identify which assays function as initial screens: ELISA, rapid immunoassays including dot blots, and latex agglutination.Exclude viral culture (too slow and not a screening tool).Select ‘‘all of these’’ among the screening formats.

Verification / Alternative check:
Algorithmic testing strategies begin with a sensitive screen followed by a highly specific confirmatory test, matching the selections here.

Why Other Options Are Wrong:
Viral culture only is not a screening approach due to logistics, biosafety, and turnaround time.

Common Pitfalls:
Confusing screening (sensitive, rapid) with confirmation (specific, often different method).

Final Answer:
all of these.