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Guiraud V, Ciczora Y, Cardona M, Defer C, Gréaume S, Nogues D, Gautheret-Dejean A. Sensitivity and specificity of the new Bio-Rad HIV screening test, Access HIV combo V2. J Clin Microbiol 2024; 62:e0009524. [PMID: 38534108 PMCID: PMC11077987 DOI: 10.1128/jcm.00095-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
Diagnosing of human immunodeficiency virus (HIV) types 1 and 2 requires a screening with a highly sensitive and specific enzyme immunoassay and a low detection limit for the HIV-1 p24 antigen to minimize the diagnostic window. The objective of the study was to determine the sensitivity, specificity, and p24 limit of detection of the Access HIV combo V2 assay. Retrospective part of sensitivity: 452 HIV-1 positive samples from 403 chronic (9 different HIV-1 group M subtypes, 22 different HIV-1 group M CRFs, and 3 HIV-1 group O), 49 primary HIV-1 infections, 103 HIV-2 positive samples assessed at Pitié-Salpêtrière Hospital, 600 untyped HIV-1, 10 subtype-D, and 159 untyped HIV-2 samples assessed in Bio-Rad Laboratories. Prospective part of clinical specificity: all consecutive samples in two blood donor facilities and Pitié-Salpêtrière (6,570 patients) tested with Access HIV combo V2 and respectively Prism HIV O Plus (Abbott) or Architect HIV Ag/Ab Combo (Abbott) for Ag/Ab screening, and Procleix Ultrio (Gen Probe) for HIV RNA screening. Limit of detection for p24 antigen was assessed on recombinant virus-like particles (10 HIV-1 group M subtypes/CRFs, HIV-1 group O). Sensitivity [95% confidence interval (CI)] of Access HIV combo V2 was 100% (99.63-100) for HIV-1 chronic infection, 100% (98.55-100) for HIV-2 chronic infection, and 100% (93.00-100) for HIV-1 primary infection. Specificity (95% CI) was 99.98 (99.91-100). Limit of detection for p24 antigen was around 0.43 IU/mL [interquartile range (0.38-0.56)], and consistent across the 11 analyzed subtypes/CRFs. Hence, with both high sensitivity and specificity, Access HIV combo V2 is a suitable screening assay for HIV-1/2 infection. IMPORTANCE Bio-Rad is one of the leading human immunodeficiency virus (HIV) screening test manufacturers. This laboratory released in 2021 their new version of the Access combo HIV test. However, to date, there have been no studies regarding its performance, especially its limit of detection of the diverse p24 antigen. We present the sensitivity (chronic and primary HIV-1 infection and HIV-2 chronic infection), specificity (blood donors and hospitalized patients), and raw data for the p24/seroconversion panels the manufacturer gave to the European agencies.
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Affiliation(s)
- Vincent Guiraud
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Virologie, Paris, France
| | | | | | - Christine Defer
- Etablissement Français du Sang (EFS) Hauts de France—Normandie, Lille, France
| | - Sandrine Gréaume
- Etablissement Français du Sang (EFS) Hauts de France—Normandie, Bois-Guillaume, France
| | | | - Agnès Gautheret-Dejean
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Virologie, Paris, France
- Université Paris cité, INSERM UMR-S 1139 Physiopathologie et pharmacotoxicologie placentaire humaine: microbiote pré & post-natal, Paris, France
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Saz J, Dalmau-Bueno A, Meulbroek M, Pujol F, Coll J, Herraiz-Tomey Á, Pérez F, Marazzi G, Taboada H, Culqui DR, Caylà JA. Use of fourth-generation rapid combined antigen and antibody diagnostic tests for the detection of acute HIV infection in a community centre for men who have sex with men, between 2016 and 2019. PLoS One 2021; 16:e0255065. [PMID: 34314468 PMCID: PMC8315512 DOI: 10.1371/journal.pone.0255065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/08/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infection of Human Immunodeficiency Virus (HIV). Methods BCN Checkpoint promotes sexual health among men who have sex with men (MSM), with a focus on diagnosing HIV early, initiating combined antiretroviral treatment (cART) promptly, and recommending regular repeat testing for those who have tested negative. This cross-sectional study included all test results obtained at the centre between 25 March 2016 and 24 March 2019. The Alere™ HIV Combo (now rebranded to Determine™ HIV Ultra, from Abbott) was used to detect p24 antigen (p24 Ag) and/or immunoglobulin M (IgM) and G (IgG) antibodies to HIV-1/HIV-2 (HIV Ab). Rapid polymerase chain reaction (PCR) confirmatory testing and Western blot (WB) were performed for clients with a positive rapid test result. Confirmed HIV cases were promptly referred to the HIV unit for care and cART prescription. Results A total of 12,961 clients attended BCN Checkpoint during the study and 27,298 rapid tests were performed. 450 tests were found to be reactive, of which 430 confirmed as HIV-positive, representing a prevalence of 3.32%. Four confirmed cases (0.93%) were detected as “p24 Ag only”, nine (2.09%) as “both p24 and HIV Ab” and 417 (96.98%) as “HIV Ab only”. The “p24 Ag only” group had a 1-log higher viral load than the other groups and initiated treatment on the following working day. Overall, there were 20 false-positive results (0.07% and 4.44% of total and reactive tests, respectively), of which 10 positive for “p24 Ag only” and 10 for “HIV Ab only”. Conclusions Four Acute HIV Infections (AHI), with very high viral loads, have been detected with the “p24 Ag only” while the HIV Ab were still absent. Referral to the HIV unit and initiation of cART on the following working day contributed to improving persons’ health and to reduce HIV transmission chain.
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Affiliation(s)
- Jorge Saz
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
- * E-mail:
| | | | | | - Ferran Pujol
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
| | - Josep Coll
- IrsiCaixa AIDS Research Institute, Fight AIDS and Infectious Diseases Foundation, Badalona, Spain
| | | | - Félix Pérez
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
| | | | | | - Dante R. Culqui
- Grupo Pulso (a company of Evidenze Group), Sant Cugat del Vallés, Spain
- Isabel Roig-Blauclinic Socio-Sanitary Centre, Barcelona, Spain
| | - Joan A. Caylà
- Tuberculosis Research Unit of Barcelona (UITB) Foundation, Barcelona, Spain
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Han H, Huang Y, Dong Q, Huang Y, Lu J, Wang W, Chen K. Clinical Application Evaluation of a Fourth-Generation HIV Antigen Antibody Combination Screening Assay. Clin Lab 2020; 65. [PMID: 31625366 DOI: 10.7754/clin.lab.2019.190220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) are infectious diseases with high mortality. Early diagnosis is crucial. Combining HIV antibody and p24 antigen, the Elecsys HIV combi PT assay is a fourth generation HIV screening assay. The sensitivity and specificity of this assay was examined. METHODS A total of 111,556 samples was conducted from January 1, 2016, to June 30, 2018 in Zhongshan Hospital of Yat-Sen University. We conducted a fourth-generation HIV test of retrospective HIV screening samples and assessed the reliability of using signal-to-cutoff (S/CO) ratios to distinguish false positive HIV antibody reactions and analyzed false positives. RESULTS A total of 122 specimens were confirmed as HIV-1 infected by western blot (WB) and HIV nucleic acid assays. The median S/CO ratio for HIV false positive specimens was 3.27, while for the HIV-infected specimen it was 391.7. Receiver operating characteristic (ROC) analysis showed that the best diagnostic point for HIV was 22.85 S/CO. The sensitivity, specificity, and Youden index were 100%, 97.8%, and 0.978, respectively. The highest false positive rate of 26.4% was found in patients with malignant tumors and blood diseases. CONCLUSIONS The results of this study show that the fourth-generation Elecsys HIV combination PT test can identify early HIV infected and can be a useful adjunct to help clinicians to manage the disease by viral load testing and starting an appropriate therapy. Our research data provides a reference for subsequent research and HIV testing in the region.
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Abstract
Rapid and reliable detection of ultralow-abundance nucleic acids and proteins in complex biological media may greatly advance clinical diagnostics and biotechnology development. Currently, nucleic acid tests rely on enzymatic processes for target amplification (e.g., PCR), which have many inherent issues restricting their implementation in diagnostics. On the other hand, there exist no protein amplification techniques, greatly limiting the development of protein-based diagnosis. We report a universal biomolecule enrichment technique termed hierarchical nanofluidic molecular enrichment system (HOLMES) for amplification-free molecular diagnostics using massively paralleled and hierarchically cascaded nanofluidic concentrators. HOLMES achieves billion-fold enrichment of both nucleic acids and proteins within 30 min, which not only overcomes many inherent issues of nucleic acid amplification but also provides unprecedented enrichment performance for protein analysis. HOLMES features the ability to selectively enrich target biomolecules and simultaneously deplete nontargets directly in complex crude samples, thereby enormously enhancing the signal-to-noise ratio of detection. We demonstrate the direct detection of attomolar nucleic acids in urine and serum within 35 min and HIV p24 protein in serum within 60 min. The performance of HOLMES is comparable to that of nucleic acid amplification tests and near million-fold improvement over standard enzyme-linked immunosorbent assay (ELISA) for protein detection, being much simpler and faster in both applications. We additionally measured human cardiac troponin I protein in 9 human plasma samples, and showed excellent agreement with ELISA and detection below the limit of ELISA. HOLMES is in an unparalleled position to unleash the potential of protein-based diagnosis.
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Affiliation(s)
- Wei Ouyang
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139
| | - Jongyoon Han
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139;
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
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Parker J, Carrasco AF, Chen J. BioRad BioPlex® HIV Ag-Ab assay: Incidence of false positivity in a low-prevalence population and its effects on the current HIV testing algorithm. J Clin Virol 2019; 116:1-3. [PMID: 30981082 DOI: 10.1016/j.jcv.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The BioPlex® HIV Ag-Ab assay, unlike other HIV 1/2 antigen/antibody immunoassays, is capable of differentiating positive HIV-1 antibodies (Groups M and O) from HIV-2 antibodies and/or HIV-1 p24 antigen in a single test. OBJECTIVE The Alaska State Virology Laboratory (ASVL) adopted the BioPlex® HIV Ag-Ab assay early 2017 and can report on its performance in terms of false positivity in a low-prevalence population and its effects on the current HIV testing algorithm recommended by the Centers for Disease Control and Prevention (CDC). STUDY DESIGN Specimens received between March 2017 and August 2018 were screened using the BioPlex® HIV Ag-Ab assay. Specimens screening positive for HIV antibodies or antigen were further confirmed using the Geenius™ HIV 1/2 Supplemental Assay and/or HIV RNA testing. RESULTS Of the 12,338 sera screened by the BioPlex assay for HIV, 35 specimens were positive. Only 22 of the specimens were confirmed by supplemental testing and were considered to be truly positive (PPV, 62.9%). RNA was not detected in these cases suggesting initial false positivity on the BioPlex® HIV Ag-Ab assay. True positive results had index values (IDX) of >180 whereas false positive IDX's were between 1 and 4, with the exception of one specimen. CONCLUSIONS We suggest that specimens demonstrating positivity with low IDX values <4 on the BioPlex® HIV Ag-Ab assay proceed directly to RNA testing, essentially bypassing supplemental antibody confirmation tests, to reduce turnaround time and cost of HIV confirmation.
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Affiliation(s)
- Jayme Parker
- Department of Health and Social Services, Division of Public Health, Alaska State Public Health Virology Laboratory, Fairbanks, Alaska, United States; Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska -Fairbanks, Fairbanks, Alaska, United States.
| | - Ana Fiorella Carrasco
- Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska -Fairbanks, Fairbanks, Alaska, United States
| | - Jack Chen
- Department of Health and Social Services, Division of Public Health, Alaska State Public Health Virology Laboratory, Fairbanks, Alaska, United States; Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska -Fairbanks, Fairbanks, Alaska, United States
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Kurdekar AD, Avinash Chunduri LA, Manohar CS, Haleyurgirisetty MK, Hewlett IK, Venkataramaniah K. Streptavidin-conjugated gold nanoclusters as ultrasensitive fluorescent sensors for early diagnosis of HIV infection. Sci Adv 2018; 4:eaar6280. [PMID: 30474052 PMCID: PMC6248912 DOI: 10.1126/sciadv.aar6280] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 10/25/2018] [Indexed: 05/14/2023]
Abstract
We have engineered streptavidin-labeled fluorescent gold nanoclusters to develop a gold nanocluster immunoassay (GNCIA) for the early and sensitive detection of HIV infection. We performed computational simulations on the mechanism of interaction between the nanoclusters and the streptavidin protein via in silico studies and showed that gold nanoclusters enhance the binding to the protein, by enhancing interaction between the Au atoms and the specific active site residues, compared to other metal nanoclusters. We also evaluated the role of glutathione conjugation in binding to gold nanoclusters with streptavidin. As proof of concept, GNCIA achieved a sensitivity limit of detection of HIV-1 p24 antigen in clinical specimens of 5 pg/ml, with a detection range up to1000 pg/ml in a linear dose-dependent manner. GNCIA demonstrated a threefold higher sensitivity and specificity compared to enzyme-linked immunosorbent assay for the detection of HIV p24 antigen. The specificity of the immunoassay was 100% when tested with plasma samples negative for HIV-1 p24 antigen and positive for viruses such as hepatitis B virus, hepatitis C virus, and dengue. GNCIA could be developed into a universal labeling technology using the relevant capture and detector antibodies for the specific detection of antigens of various pathogens in the future.
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Affiliation(s)
- Aditya Dileep Kurdekar
- Laboratories for Nanoscience and Nanotechnology Research, Department of Physics, Sri Sathya Sai Institute of Higher Learning, Prasanthinilayam, Andhra Pradesh, India
| | - L. A. Avinash Chunduri
- Andhra Med Tech Zone, Hill No. 2, IT Park Madhurwada, Rushikonda, Vishakhapatnam, Andhra Pradesh 530045, India
| | - C. Sai Manohar
- Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthinilayam, India
| | - Mohan Kumar Haleyurgirisetty
- Laboratory of Molecular Virology, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Indira K. Hewlett
- Laboratory of Molecular Virology, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Kamisetti Venkataramaniah
- Laboratories for Nanoscience and Nanotechnology Research, Department of Physics, Sri Sathya Sai Institute of Higher Learning, Prasanthinilayam, Andhra Pradesh, India
- Corresponding author.
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Abstract
: Despite major advances in HIV testing, early detection of infection at the point of care (PoC) remains a key challenge. Although rapid antibody PoC and laboratory-based nucleic acid amplification tests dominate the diagnostics market, the viral capsid protein p24 is recognized as an alternative early virological biomarker of infection. However, the detection of ultra-low levels of p24 at the PoC has proven challenging. Here we review the landscape of p24 diagnostics to identify knowledge gaps and barriers and help shape future research agendas. Five hundred and seventy-four research articles to May 2018 that propose or evaluate diagnostic assays for p24 were identified and reviewed. We give a brief history of diagnostic development, and the utility of p24 as a biomarker in different populations such as infants, the newly infected, those on preexposure prophylaxis and self-testers. We review the performance of commercial p24 assays and consider elements such as immune complex disruption, resource-poor settings, prevalence, and assay antibodies. Emerging and ultrasensitive assays are reviewed and show a number of promising approaches but further translation has been limited. We summarize studies on the health economic benefits of using antigen testing. Finally, we speculate on the future uses of high-performance p24 assays, particularly, if available in self-test format.
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Affiliation(s)
- Eleanor R Gray
- London Centre for Nanotechnology, Faculty of Maths and Physical Sciences, University College London
| | - Robert Bain
- Department of Materials, Department of Bioengineering and Institute of Biomedical Engineering, Imperial College London
| | | | | | - Molly M Stevens
- Department of Materials, Department of Bioengineering and Institute of Biomedical Engineering, Imperial College London
| | - Rachel A McKendry
- London Centre for Nanotechnology, Faculty of Maths and Physical Sciences, University College London
- Division of Medicine, University College London, London, UK
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Ghisetti V, Coignard C, Allice T, Thoai Duong L. Evaluation of the performance of a new automated HIV combination assay. J Clin Virol 2017; 96:80-83. [PMID: 29020658 DOI: 10.1016/j.jcv.2017.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/04/2017] [Accepted: 09/18/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND More and more countries test for HIV infection using combination assays that simultaneously detect p24 antigen and HIV antibodies. OBJECTIVE To assess the performance of a new HIV combo assay: LIAISON® XL murex HIV Ab/Ag HT. STUDY DESIGN The assays were examined with a total of 3090 samples that included 769 selected HIV antibody-negative samples, 1849 unselected HIV samples, 15 HIV-1 p24 Ag reference samples, 90 primary HIV-1 infection (PHI) samples, 167 HIV-1 antibody-positive samples (well characterized of groups M and O), 95 HIV-1 antibody-positive samples and 105 HIV-2 antibody-positive samples. RESULTS The specificity of the LIAISON® XL murex HIV Ab/Ag HT was 99.7%. The analytical sensitivity of Ag p24 of the LIAISON® XL murex HIV Ab/Ag HT was 0.58IU/mL and 9.93pg/mL when using WHO and French national standards, respectively. All screened HIV subtypes was identified by this assay. Also, 90 PHI specimens were detected by this screening assay. CONCLUSION The sensitivity and specificity of the LIAISON® XL murex HIV Ab/Ag HT assay are high. Hence the assay offers automated high-throughput screening with ability to detect primary infection.
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Affiliation(s)
- Valeria Ghisetti
- Laboratory Microbiology, Amedeo di Savoia Hospital, Turin, Italy.
| | | | - Tiziano Allice
- Laboratory Microbiology, Amedeo di Savoia Hospital, Turin, Italy.
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Kosaka PM, Pini V, Calleja M, Tamayo J. Ultrasensitive detection of HIV-1 p24 antigen by a hybrid nanomechanical-optoplasmonic platform with potential for detecting HIV-1 at first week after infection. PLoS One 2017; 12:e0171899. [PMID: 28199410 PMCID: PMC5310927 DOI: 10.1371/journal.pone.0171899] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 01/27/2017] [Indexed: 01/03/2023] Open
Abstract
Early detection of HIV infection is the best way to prevent spread of the disease and to improve the efficiency of the antiretroviral therapy. Nucleic acid amplification tests (NAAT) have become the gold-standard for detecting low-concentrations of the virus in blood. However, these methods are technically demanding and cost-prohibitive in developing countries. Immunoassays are more affordable and can be more easily adapted for point-of-care diagnosis. However, the sensitivity so far of these methods has been too low. We here report the development of a sandwich immunoassay that combines nanomechanical and optoplasmonic transduction methods for detecting the HIV-1 capsid antigen p24 in human serum. The immunoreactions take place on the surface of a compliant microcantilever where gold nanoparticles are used as both mechanical and plasmonic labels. The microcantilever acts as both a mechanical resonator and an optical cavity for the transduction of the mechanical and plasmonic signals. The limit of detection of the immunoassay is 10−17 g/mL that is equivalent to one virion in 10 mL of plasma. This is 5 orders of magnitude better than last generation of approved immunoassays and 2 orders of magnitude better than NAAT. This technology meets the demands to be produced en masse at low cost and the capability for miniaturization to be used at the point-of-care.
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Affiliation(s)
- Priscila M. Kosaka
- IMM–Instituto de Microelectrónica de Madrid (CNM-CSIC), Isaac Newton, 8, PTM, Tres Cantos, Madrid, Spain
- * E-mail: (JT); (PMK)
| | - Valerio Pini
- IMM–Instituto de Microelectrónica de Madrid (CNM-CSIC), Isaac Newton, 8, PTM, Tres Cantos, Madrid, Spain
| | - Montserrat Calleja
- IMM–Instituto de Microelectrónica de Madrid (CNM-CSIC), Isaac Newton, 8, PTM, Tres Cantos, Madrid, Spain
| | - Javier Tamayo
- IMM–Instituto de Microelectrónica de Madrid (CNM-CSIC), Isaac Newton, 8, PTM, Tres Cantos, Madrid, Spain
- * E-mail: (JT); (PMK)
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Nehilla BJ, Hill JJ, Srinivasan S, Chen YC, Schulte TH, Stayton PS, Lai JJ. A Stimuli-Responsive, Binary Reagent System for Rapid Isolation of Protein Biomarkers. Anal Chem 2016; 88:10404-10410. [PMID: 27686335 PMCID: PMC6750004 DOI: 10.1021/acs.analchem.6b01961] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Magnetic microbeads exhibit rapid separation characteristics and are widely employed for biomolecule and cell isolations in research laboratories, clinical diagnostics assays, and cell therapy manufacturing. However, micrometer particle diameters compromise biomarker recognition, which leads to long incubation times and significant reagent demands. Here, a stimuli-responsive binary reagent system is presented that combines the nanoscale benefits of efficient biomarker recognition and the microscale benefits of rapid magnetic separation. This system comprises magnetic nanoparticles and polymer-antibody (Ab) conjugates that transition from hydrophilic nanoscale reagents to microscale aggregates in response to temperature stimuli. The binary reagent system was benchmarked against Ab-labeled Dynabeads in terms of biomarker isolation kinetics, assay speed, and reagent needs. Surface plasmon resonance (SPR) measurements showed that polymer conjugation did not significantly alter the Ab's binding affinity or kinetics. ELISA analysis showed that the unconjugated Ab, polymer-Ab conjugates, and Ab-labeled Dynabeads exhibited similar equilibrium dissociation constants (Kd), ∼2 nM. However, the binary reagent system isolated HIV p24 antigen from spiked serum specimens (150 pg/mL) much more quickly than Dynabeads, which resulted in shorter binding times by tens of minutes, or about 30-50% shorter overall assay times. The binary reagent system showed improved performance because the Ab molecules were not conjugated to large, solid microparticle surfaces. This stimuli-responsive binary reagent system illustrates the potential advantages of nanoscale reagents in molecule and cell isolations for both research and clinical applications.
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Affiliation(s)
| | - John J. Hill
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Selvi Srinivasan
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Yen-Chi Chen
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Thomas H. Schulte
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Patrick S. Stayton
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - James J. Lai
- Department of Bioengineering, University of Washington, Seattle, WA 98195
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Sanders EJ, Wahome E, Powers KA, Werner L, Fegan G, Lavreys L, Mapanje C, McClelland RS, Garrett N, Miller WC, Graham SM. Targeted screening of at-risk adults for acute HIV-1 infection in sub-Saharan Africa. AIDS 2015; 29 Suppl 3:S221-30. [PMID: 26562811 PMCID: PMC4714928 DOI: 10.1097/qad.0000000000000924] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients with acute HIV-1 infection (AHI) have elevated infectivity, but cannot be diagnosed using antibody-based testing. Approaches to screen patients for AHI are urgently needed to enable counselling and treatment to reduce onward transmission. METHODS We pooled data from four African studies of high-risk adults that evaluated symptoms and signs compatible with acute retroviral syndrome and tested for HIV-1 at each visit. AHI was defined as detectable plasma viral load or p24 antigen in an HIV-1-antibody-negative patient who subsequently seroconverted. Using generalized estimating equation, we identified symptoms, signs, and demographic factors predictive of AHI, adjusting for study site. We assigned a predictor score to each statistically significant predictor based on its beta coefficient, summing predictor scores to calculate a risk score for each participant. We evaluated the performance of this algorithm overall and at each site. RESULTS We compared 122 AHI visits with 45 961 visits by uninfected patients. Younger age (18-29 years), fever, fatigue, body pains, diarrhoea, sore throat, and genital ulcer disease were independent predictors of AHI. The overall area under the receiver operating characteristics curve (AUC) for the algorithm was 0.78, with site-specific AUCs ranging from 0.61 to 0.89. A risk score of at least 2 would indicate AHI testing for 5-50% of participants, substantially decreasing the number needing testing. CONCLUSION Our targeted risk score algorithm based on seven characteristics reduced the number of patients needing AHI testing and had good performance overall. We recommend this risk score algorithm for use by HIV programs in sub-Saharan Africa with capacity to test high-risk patients for AHI.
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Affiliation(s)
- Eduard J. Sanders
- Centre for Geographic Medicine Research – Coast, Kenya Medical Research Institute (KEMRI) – Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Headington, UK
- Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Elizabeth Wahome
- Centre for Geographic Medicine Research – Coast, Kenya Medical Research Institute (KEMRI) – Kilifi, Kenya
| | - Kimberly A. Powers
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa Werner
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Greg Fegan
- Centre for Geographic Medicine Research – Coast, Kenya Medical Research Institute (KEMRI) – Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Headington, UK
| | | | | | - R. Scott McClelland
- Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, Washington
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - William C. Miller
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Susan M. Graham
- Centre for Geographic Medicine Research – Coast, Kenya Medical Research Institute (KEMRI) – Kilifi, Kenya
- Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, Washington
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Nakatsuma A, Kaneda M, Kodama H, Morikawa M, Watabe S, Nakaishi K, Yamashita M, Yoshimura T, Miura T, Ninomiya M, Ito E. Detection of HIV-1 p24 at Attomole Level by Ultrasensitive ELISA with Thio-NAD Cycling. PLoS One 2015; 10:e0131319. [PMID: 26098695 PMCID: PMC4476629 DOI: 10.1371/journal.pone.0131319] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/01/2015] [Indexed: 01/12/2023] Open
Abstract
To reduce the window period between HIV-1 infection and the ability to diagnose it, a fourth-generation immunoassay including the detection of HIV-1 p24 antigen has been developed. However, because the commercially available systems for this assay use special, high-cost instruments to measure, for example, chemiluminescence, it is performed only by diagnostics companies and hub hospitals. To overcome this limitation, we applied an ultrasensitive ELISA coupled with a thio-NAD cycling, which is based on a usual enzyme immunoassay without special instruments, to detect HIV-1 p24. The p24 detection limit by our ultrasensitive ELISA was 0.0065 IU/assay (i.e., ca. 10-18 moles/assay). Because HIV-1 p24 antigen is thought to be present in the virion in much greater numbers than viral RNA copies, the value of 10-18 moles of the p24/assay corresponds to ca. 103 copies of the HIV-1 RNA/assay. That is, our ultrasensitive ELISA is chasing the detection limit (102 copies/assay) obtained by PCR-based nucleic acid testing (NAT) with a margin of only one different order. Further, the detection limit by our ultrasensitive ELISA is less than that mandated for a CE-marked HIV antigen/antibody assay. An additional recovery test using blood supported the reliability of our ultrasensitive ELISA.
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Affiliation(s)
- Akira Nakatsuma
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
| | - Mugiho Kaneda
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
| | - Hiromi Kodama
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
| | - Mika Morikawa
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
- TAUNS Laboratories, Inc., Izunokuni, Japan
| | | | | | | | - Teruki Yoshimura
- Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan
| | - Toshiaki Miura
- Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Masaki Ninomiya
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
| | - Etsuro Ito
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
- * E-mail:
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Vermeulen M, Coleman C, Mitchel J, Reddy R, van Drimmelen H, Fickett T, Busch M, Lelie N. Comparison of human immunodeficiency virus assays in window phase and elite controller samples: viral load distribution and implications for transmission risk. Transfusion 2013; 53:2384-98. [PMID: 23445273 PMCID: PMC5061040 DOI: 10.1111/trf.12117] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 12/04/2012] [Accepted: 12/04/2012] [Indexed: 01/02/2023]
Abstract
BACKGROUND After 3 years of individual-donation nucleic acid test (ID-NAT) screening by the South African National Blood Service (SANBS), a repository of 73 human immunodeficiency virus antibody (anti-HIV)-negative window period (WP)-yield samples and 28 anti-HIV-positive, HIV-RNA-negative elite controllers (ECs) became available for comparison of a p24 antigen (p24 Ag) assay (Innogenetics), two viral load assays (Siemens branch DNA [bDNA] 3.0 and Abbott real-time polymerase chain reaction [RT-PCR]), and three triplex NAT assays (Novartis Diagnostics Ultrio and Ultrio-Plus and Roche TaqScreen) by replicate testing of dilutions. STUDY DESIGN AND METHODS Viral loads were assessed by bDNA and RT-PCR assays and if below 100 copies (cps)/mL, by Ultrio limiting dilution probit analysis. The probability of virus transmission by WP and EC donations was estimated for different levels of the 50% minimum infectious dose (ID50 ) using Poisson distribution statistics. RESULTS The equal distribution of WP donations plotted by log HIV-RNA levels indicated a random appearance of donors in the ramp-up phase. The HIV p24 Ag assay detected 45% of WP samples and the cutoff crossing point was estimated at 8140 (bDNA)/22,710 (RT-PCR) cps/mL. On replicate retesting of 40 HIV p24 Ag-negative ID-NAT WP-yield samples Ultrio minipool (MP)8, Ultrio-Plus MP8, and TaqScreen MP6 detected 79, 81, and 78%, respectively. Modeling with an estimated ID50 of 31.6 virions/RBC indicated that 15% of p24 Ag-negative ID-NAT WP-yield donations would have transmitted HIV if MP6-8 NAT had been used. Only 2% of RBC transfusions from ECs are estimated to be infectious with a worst-case ID50 estimate of 316 virions. CONCLUSION Our analysis of viremia and infectivity of WP and EC donations enables comparison of the efficacy of NAT options in preventing HIV transmission risk.
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Affiliation(s)
- Marion Vermeulen
- South African National Blood Service (SANBS), Johannesburg, South Africa; BioQControl, DDL Laboratories, Rijswijk, Netherlands; Creative Testing Solutions, Tampa, Florida; Blood Systems Research Institute, San Francisco, California; Lelie Research Paris, Paris, France
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de la Rica R, Stevens MM. Plasmonic ELISA for the ultrasensitive detection of disease biomarkers with the naked eye. Nat Nanotechnol 2012; 7:821-4. [PMID: 23103935 DOI: 10.1038/nnano.2012.186] [Citation(s) in RCA: 562] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/23/2012] [Indexed: 05/20/2023]
Abstract
In resource-constrained countries, affordable methodologies for the detection of disease biomarkers at ultralow concentrations can potentially improve the standard of living. However, current strategies for ultrasensitive detection often require sophisticated instruments that may not be available in laboratories with fewer resources. Here, we circumvent this problem by introducing a signal generation mechanism for biosensing that enables the detection of a few molecules of analyte with the naked eye. The enzyme label of an enzyme-linked immunosorbent assay (ELISA) controls the growth of gold nanoparticles and generates coloured solutions with distinct tonality when the analyte is present. Prostate specific antigen (PSA) and HIV-1 capsid antigen p24 were detected in whole serum at the ultralow concentration of 1 × 10(-18) g ml(-1). p24 was also detected with the naked eye in the sera of HIV-infected patients showing viral loads undetectable by a gold standard nucleic acid-based test.
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Affiliation(s)
- Roberto de la Rica
- Department of Materials, Department of Bioengineering and Institute for Biomedical Engineering, Imperial College London, Exhibition Road, London, UK.
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Naylor E, Axten D, Makia F, Tong C, White J, Fox J. Fourth generation point of care testing for HIV: validation in an HIV-positive population. Sex Transm Infect 2011; 87:311. [PMID: 21593469 DOI: 10.1136/sextrans-2011-050056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Recent FDA approvals and changes. AIDS Patient Care STDS 2010; 24:528. [PMID: 20712509 DOI: 10.1089/apc.2010.9898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Laboratory tests are readily available for the diagnosis of HIV infection. These are based on the detection of HIV-specific antibodies and HIV p24 antigen in combination screening assays, followed by confirmation by Western blot. Managing established HIV infection, including the use of antiretroviral drugs, has been facilitated by the use of nucleic acid tests that measure HIV RNA load in plasma or detect mutations associated with drug resistance. Quality assurance programs ensure high-level performance of HIV assays.
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Affiliation(s)
- Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital.
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Abbott submits new HIV test for expedited review. AIDS Patient Care STDS 2010; 24:136. [PMID: 20183932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Baranova EN, Sharipova IN, Denisova NM, Susekina ME, Puzyrev VF, Sarkisian KA, Vorob'eva MS, Burkov AN, Ulanova TI. [The capacities of current test systems to verify early HIV infection]. Vopr Virusol 2009; 54:37-40. [PMID: 19882902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of the present investigation was to comparatively evaluate the performance characteristics of the test systems designed to verify the positive results of screening survey for HIV infection, such as the solid-phase immunoassay DS-EIA-HIV-AB/AG-SPECTR (Diagnosticheskiye Sistemy (Diagnostic Systems) Research-and-Production Association, Nizhni Novgorod) and tests based on immune blotting (IB). The investigation examined 15 seroconversion panels produced by ZeptoMetrix (USA) and BBI (USA). The use of the DS-EIA-HIV-AB/AG-SPECTR test system determined 88 of the 167 seroconversion panels as HIV positive. The IB-based tests revealed only 45 of the 167 samples as positive. Consequently, the application of the DS-EIA-HIV-AB/AG-SPECTR test system is more effective than the IB-based tests in early HIV infection.
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Mazza P, Bocchia M, Tumietto F, Costigliola P, Coronado O, Bandini G, Conte R, Ricchi E, Vianelli N, Raise E. Recombinant interleukin-2 (rIL-2) in acquired immune deficiency syndrome (AIDS): Preliminary report in patients with lymphoma associated with HIV infection. Eur J Haematol 2009; 49:1-6. [PMID: 1354168 DOI: 10.1111/j.1600-0609.1992.tb00905.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In an ongoing phase II study, 12 patients with lymphoma and HIV infection were treated with zidovudine (ZDV) and recombinant interleukin-2 (rIL-2) to evaluate if this association may produce beneficial effect on the immunologic status and the outcome of lymphoma. The protocol included daily doses of rIL-2 at 6 MIU/m2 over 5 days in c.i. per week for a total 4 courses; ZDV was associated at 600 mg/d in the period under study. An improved CD4 count, exceeding 2- to 4-fold the basal count, was obtained in patients with a basal CD4 number greater than 100/microliters accompanied by a significant increase of NK and LAK activity (p less than 0.001). From the clinical point of view the reduction of tumor manifestation was proportional to CD4 basal number; 2 patients from those with CD4 greater than 100/microliters obtained a complete remission after rIL-2 and ZVD. The p24 antigen, taken as parameter of viral replication, remained invariably negative after rIL-2 and ZDV in patients already negative and became negative in 1 patient previously positive. Our conclusion is that the association of rIL-2 and AZT is safe and useful in patients with lymphoma and HIV infection.
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Affiliation(s)
- P Mazza
- Institute of Hematology, University of Bologna, Italy
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Neshumaev DA, Ol'khovskiĭ IA, Baranova EN, Sharipova IN, Ulanova TI, Vinogradova MN, Shevchenko NM, Ruzaeva LA. [Predictive value of detection of HIV p24 antigen in the use of test systems with increased analytical sensitivity]. Klin Lab Diagn 2009:40-42. [PMID: 19334477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Ndongala ML, Peretz Y, Boulet S, Doroudchi M, Yassine-Diab B, Boulassel MR, Rouleau D, Tremblay C, LeBlanc R, Routy JP, Sékaly RP, Bernard NF. HIV Gag p24 specific responses secreting IFN-gamma and/or IL-2 in treatment-naïve individuals in acute infection early disease (AIED) are associated with low viral load. Clin Immunol 2009; 131:277-87. [PMID: 19135418 DOI: 10.1016/j.clim.2008.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 11/19/2008] [Accepted: 11/21/2008] [Indexed: 01/29/2023]
Abstract
HIV-specific immune responses in acute infection early disease (AIED) may be effective at controlling viral replication and in establishing viral load (VL) set point. However, evidence correlating the function and specificity of these responses with the VL set point is lacking. To address this issue, we screened cells from 59 treatment-naïve HIV infected individuals (33 in AIED and 26 progressors) for responses to the entire HIV proteome using a dual color ELISPOT assay detecting 3 functional lymphocyte populations: single IFN-gamma, dual IFN-gamma/IL-2 and single IL-2 secreting cells. Responses characterized by dual secreting cells contributed more to the HIV specific response in AIED versus chronic infection. Of responses directed to individual HIV gene products the magnitude and breadth of only Gag p24-specific responses for the 3 functional subsets were associated with lower concurrent or set point VL. Therefore the early appearance of broader and more intense Gag-p24-specific responses may be a determinant of subsequent VL.
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Affiliation(s)
- Michel L Ndongala
- Research Institute of the McGill University Health Center, Montreal General Hospital, Quebec, Canada
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Ruzaeva LA, Ol'khovskiĭ IA, Neshumaev DA, Shevchenko NM, Vinogradova MN. [Value of enzyme-linked immunosorbent assay for detection of p24 antigen of human immunodeficiency virus in confirmation of HIV-infection]. Zh Mikrobiol Epidemiol Immunobiol 2008:19-22. [PMID: 19186539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM To evaluate diagnostic value of p24 antigen detection for algorithm of confirmatory diagnostics of HIV-infection. MATERIALS AND METHODS Concurrently with Western blot assay (WB, "New Lav Blot1", Bio-Rad), tests for detection of p24 antigen of HIV (Genetic Systems HIV-1 Ag EIA", "VectoHIV-1 p24-antigen confirming test", and "DS-EIA-HIV-AG-SCREEN") were used for confirmation of first-positive result of immuno-enzyme assay. RESULTS p24 HIV antigen was detected in serum samples in 8.4% of patients with equivocal result of WB and in 4.2% of patients with negative and positive results of WB. Presence of p24 was correlated with high viral load, and, in patients with confirmed diagnosis, with low CD4 cells count (<500 cells/ml). p24 was detected in more than 30% of persons with confirmed seroconversion after primary testing. CONCLUSION In groups of persons with negative and equivocal results of WB assay, detection of HIV p24 antigen points to the presence of infection and could be the reason for the final diagnosis. Detection of p24 in patients with positive result of WB assay allows to consider them as probable candidates for highly active antiretroviral therapy.
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26
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Sharipova IN, Levina MA, Baranova EN, Obriadina AP, Burkov AN, Ulanova TI. [A novel enzyme immunoassay system for the detection of HIV-1 p24 antigen with a sensitivity of 0.5 pg/ml]. Klin Lab Diagn 2008:41-42. [PMID: 19069445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A "DS-EIA-HIV-AG-Screen" enzyme immunoassay system has been devised to detect HIV-1 p24 antigen with a sensitivity of 0.5 pg/ml the use of which permits reduction of a seronegative window phase as compared with the tests showing a lower sensitivity threshold. The "DS-EIA-HIV-AG-Screen" system developed may be used to screen donor blood and to examine risk-group individuals for the early diagnosis of HIV infection.
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Thaikruea L, Nantachit N, Leetrakool N, Fongsatitkul L, Sompan P, Heaton A, Nelson KE. Assessment of a self-deferral form for screening blood donors, Chiang Mai University Hospital, Thailand. Southeast Asian J Trop Med Public Health 2008; 39:906-912. [PMID: 19058588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A self-deferral form has been used to screen Chiang Mai University Hospital blood donors and was improved in 2005. It has never been evaluated. The study aimed to assess the self-deferral form procedures in detecting infected donors. Sera from 5,083 donors, who passed the self-deferral screening form, were tested with the routine immuno-assays (serology) for HIV 1 and 2 antibodies, P24 antigen, HCV antibodies, HBV surface antigen, and syphilis. Antibody negative sera were also tested individually with the the Procleix Ultrio Assay for HIV-1 DNA, HCV RNA, and HBV DNA. The donors who had discrepant results between serology and NAT were evaluated with additional tests, including a more sensitive Alternative Nucleic Acid Test, AntiBcore IgM, AntiBcore IgG, HBsAg and Anti HBs. Among 5,083 donors, 331 (6.5%) had at least one positive marker. In multiple logistic regression analysis, the statistically significant factors (adjusted odds ratio and 95% CI) for infection were age 30 years or below [1.45 (1.03, 2.03)], male gender [2.73 (1.64, 4.56)], primary school or lower education [1.56 (1.09, 2.23)], first-time donation [1.82 (1.25, 2.67)], and frequent donation [0.80 (0.70, 0.92)]. The safest donors were females, older than 30 years, with an education more than primary school, and frequent donation. Because of missing responses to some sensitive questions, there remains a need for further improvement of the self-deferral form.
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Affiliation(s)
- Lakkana Thaikruea
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Smith GM, Forbes MA, Cooper J, Bradley T, Hambling MH, Cooper EH, McVerry BA. Prognostic indicators for the development of AIDS in HIV antibody positive haemophiliac patients: results of a three-year longitudinal study. Clin Lab Haematol 2008; 13:115-25. [PMID: 1934922 DOI: 10.1111/j.1365-2257.1991.tb00260.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In February 1986, 40 out of 75 adult patients with haemophilia A attending St. James's University Hospital were human immunodeficiency virus (HIV) antibody positive. Over a three-year period these patients were prospectively studied with regard to possible prognostic indicators for the development of the acquired immune deficiency syndrome (AIDS). Using the Centres for Disease Control (CDC) classification of HIV infection, 17 patients (42.5%) developed group 4 disease during this time, giving an actuarial three-year progression rate of 44%, and 5 patients (12.5%) died. The following parameters measured at recruitment were found independently to predict progression to AIDS: a serum beta 2-m level of greater than 3.5 mg/l, (chi 2 = 15.95, P less than 0.001), a serum IgA level of greater than 4.5 milligram(s) (chi 2 = 6.08, P less than 0.02) and p24 antigenaemia (chi 2 = 5.7, P less than 0.05). The actuarial three-year progression rate in those patients abnormal by two or more of these parameters was 100% (n = 7), compared to only 7% in patients who were normal by all three values (n = 15). CD4+ lymphocyte counts and CD4+:CD8+ ratios were significantly lower in HIV positive compared with HIV negative patients (P less than 0.01), but did not predict the development of AIDS.
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Affiliation(s)
- G M Smith
- Department of Haematology, St. James's University Hospital, Leeds
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Kim EY, Stanton J, Korber BTM, Krebs K, Bogdan D, Kunstman K, Wu S, Phair JP, Mirkin CA, Wolinsky SM. Detection of HIV-1 p24 Gag in plasma by a nanoparticle-based bio-barcode-amplification method. Nanomedicine (Lond) 2008; 3:293-303. [PMID: 18510425 PMCID: PMC2821699 DOI: 10.2217/17435889.3.3.293] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Detection of HIV-1 in patients is limited by the sensitivity and selectivity of available tests. The nanotechnology-based bio-barcode-amplification method offers an innovative approach to detect specific HIV-1 antigens from diverse HIV-1 subtypes. We evaluated the efficacy of this protein-detection method in detecting HIV-1 in men enrolled in the Chicago component of the Multicenter AIDS Cohort Study (MACS). METHODS The method relies on magnetic microparticles with antibodies that specifically bind the HIV-1 p24 Gag protein and nanoparticles that are encoded with DNA and antibodies that can sandwich the target protein captured by the microparticle-bound antibodies. The aggregate sandwich structures are magnetically separated from solution, and treated to remove the conjugated barcode DNA. The DNA barcodes (hundreds per target) were identified by a nanoparticle-based detection method that does not rely on PCR. RESULTS Of 112 plasma samples from HIV-1-infected subjects, 111 were positive for HIV-1 p24 Gag protein (range: 0.11-71.5 ng/ml of plasma) by the bio-barcode-amplification method. HIV-1 p24 Gag protein was detected in only 23 out of 112 men by the conventional ELISA. A total of 34 uninfected subjects were negative by both tests. Thus, the specificity of the bio-barcode-amplification method was 100% and the sensitivity 99%. The bio-barcode-amplification method detected HIV-1 p24 Gag protein in plasma from all study subjects with less than 200 CD4(+) T cells/microl of plasma (100%) and 19 out of 20 (95%) HIV-1-infected men who had less than 50 copies/ml of plasma of HIV-1 RNA. In a separate group of 60 diverse international isolates, representative of clades A, B, C and D and circulating recombinant forms CRF01_AE and CRF02_AG, the bio-barcode-amplification method identified the presence of virus correctly. CONCLUSIONS The bio-barcode-amplification method was superior to the conventional ELISA assay for the detection of HIV-1 p24 Gag protein in plasma with a breadth of coverage for diverse HIV-1 subtypes. Because the bio-barcode-amplification method does not require enzymatic amplification, this method could be translated into a robust point-of-care test.
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Affiliation(s)
- Eun-Young Kim
- Division of Infectious Diseases, The Feinberg School of Medicine, Northwestern University, 676 North St. Clair, Chicago, IL 60611, USA
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Derveaux S, Stubbe BG, Roelant C, Leblans M, De Geest BG, Demeester J, De Smedt SC. Layer-by-layer coated digitally encoded microcarriers for quantification of proteins in serum and plasma. Anal Chem 2008; 80:85-94. [PMID: 18052131 DOI: 10.1021/ac071212i] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The "layer-by-layer" (LbL) technology has been widely investigated for the coating of flat substrates and capsules with polyelectrolytes. In this study, LbL polyelectrolyte coatings applied at the surface of digitally encoded microcarriers were evaluated for the quantitative, sensitive, and simultaneous detection of proteins in complex biological samples like serum, plasma, and blood. LbL coated microcarriers were therefore coupled to capture antibodies, which were used as capture agents for the detection of tumor necrosis factor (TNF-alpha), P24, and follicle stimulating hormone (FSH). It was found that the LbL coatings did not disassemble upon incubating the microcarriers in serum and plasma. Also, nonspecific binding of target analytes to the LbL coating was not observed. We showed that the LbL coated microcarriers can reproducibly detect TNF-alpha, P24, and FSH down to the picogram per milliliter level, not only in buffer but also in serum and plasma samples. Microcarrier-to-microcarrier intratube variations were less then 30%, and interassay variations less than 8% were observed. This paper also shows evidence that the LbL coated digitally encoded microcarriers are ideally suited for assaying proteins in "whole" blood in microfluidic chips, which are of high interest for "point-of-care" diagnostics.
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Affiliation(s)
- Stefaan Derveaux
- Laboratory of General Biochemistry and Physical Pharmacy, University of Ghent, Harelbekestraat 72, 9000 Ghent, Belgium
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Hu Y, Hou J, Feng YQ, Feng CF, Shi SJ, Shen HHH, Wang ZJ, Wang BJ, Mao PY. [Establishment and evaluation of the diagnostic kit for anti-HIV1/2 antibody and P24 antigen]. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 2007; 21:391-393. [PMID: 18322614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To establish and evaluate an Enzyme Immunoassay diagnostic kit combined with anti-HIV1/2 antibody and P24 antigen for shortening the examination window period of HIV infection in HIV laboratory diagnosis. METHODS The enzyme-linked reaction plates was coated by anti-HIV P24 monoclonal antibody and HIV 1/2 antigen. Labeling HIV1/2 antigen and anti-HIV P24 polyclonal antibody with horseradish peroxidase, setup an integrated ELISA kit for detecting anti-HIV-1/2 antibody and HIV P24 antigen, and evaluate the specificity and sensitivity of this kit. RESULTS The sensitivity of testing P24 antigen was up to 0.2 ng/ml. 78 serum samples of patients with AIDS, 85 serum samples of healthy people were compared with Abbott EIA kit, the coincidence was 100%. 12 051 sera from normal persons and patients were examined, the sensitivity of 100 %and specificity of 99.62 %, respectively. CONCLUSION The anti-HIV1/2 antibody and HIV P24 antigen can be measured at the same time using this EIA kit, while the examination window period of HIV infection is shortened. Thus, the method is suitable for laboratory diagnosis and epidemiological investigation.
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Affiliation(s)
- Yan Hu
- Department of Virology, 302nd Hospital of PLA, Beijing, 100039, China
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Creek TL, Sherman GG, Nkengasong J, Lu L, Finkbeiner T, Fowler MG, Rivadeneira E, Shaffer N. Infant human immunodeficiency virus diagnosis in resource-limited settings: issues, technologies, and country experiences. Am J Obstet Gynecol 2007; 197:S64-71. [PMID: 17825652 DOI: 10.1016/j.ajog.2007.03.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Revised: 02/16/2007] [Accepted: 03/01/2007] [Indexed: 11/18/2022]
Abstract
Diagnosing human immunodeficiency virus (HIV) infection in infants is difficult because maternal HIV antibodies cross the placenta, causing positive serologic tests in HIV-exposed infants for the first several months of life. Early definitive diagnosis of HIV requires virologic testing such as polymerase chain reaction (PCR), which is the diagnostic standard in resource-rich settings but has been too complex and expensive for widespread use in most countries with high HIV prevalence. Early PCR testing can help HIV-infected infants access treatment, provide psychosocial benefits for families of uninfected infants, and help programs for prevention of mother-to-child transmission of HIV monitor their effectiveness. HIV testing, including PCR, is increasingly available for infants in resource-limited settings, but there are many barriers and complex policy decisions that need to be addressed before universal early testing can become standard. This paper reviews challenges and progress in the field and suggests ways to facilitate early infant testing in resource-limited settings.
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Affiliation(s)
- Tracy L Creek
- Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA 30333, USA.
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Abstract
Clinical observations suggest that HIV-1 infection causes higher anemia rates in patients in southern Africa than in those in the United States. To explore this difference we performed a cross-sectional exploratory study on the effect of HIV-1 infection on hematopoiesis in Botswana by examining hematological presentation, HIV disease state, hematopoietic progenitor cell number, and circulating viral levels in HIV-infected patients and HIV-uninfected controls. We found significant associations between CD34(+) and CD4(+) cell counts in HIV-positive patients. Significant relationships were also seen between the CD34(+) CD4(+) cell population and hemoglobin levels, as well as colony-forming ability. These associations, however, were not seen in uninfected controls. Circulating viral p24 levels were found to correlate significantly with CD34(+) cell count, CD34(+) CD4(+) cell count, and colony-forming ability. These results demonstrate a direct association between HIV-1 infection in southern Africa and hematopoietic progenitor cell health.
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Affiliation(s)
- Andrew D Redd
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts 02115, USA
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Gendler SA, Pascuccio MS. Routine HIV screening among blood donors in Buenos Aires (Argentina): results from six years' experience and report of a single window-period donation. Enferm Infecc Microbiol Clin 2007; 25:82-90. [PMID: 17288905 DOI: 10.1157/13098568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Blood donor HIV antibody detection has been mandatory in Argentina since 1991, and p24 antigen screening was recommended in 1997. METHODS A total of 30,132 consecutive donations were screened. Repeatedly reactive samples were tested by another screening test and/or by Western blot (WB) for HIV Ab, or by a neutralization assay for p24 Ag. RESULTS Among the total, 0.3623% of samples were repeatedly reactive and 0.2084% were true HIV-infected donors. Only one donor tested nonreactive for HIV Ab, repeatedly reactive for p24 Ag, positive by neutralization assay, and seroconverted later. Samples with a signal-to-cutoff (S/CO) ratio >/= 3.00 on routine HIV Ab testing were 100.0% positive by WB and/or repeatedly reactive by the second test. In samples with a S/CO ratio < 3.00, 11.1% were positive by WB and/or the majority were nonreactive by the second test. Among HIV-infected donors, 89.5% possessed risk factors (which had been denied previously), 56.5% were repeatedly reactive by other screening procedures and 88.6% were coinfected with other blood-transmissible viruses. CONCLUSIONS When the EIA S/CO ratio is >/= 3.00, WB can be replaced by a second screening test. The pre-donation questionnaire should be improved to detect risk behavior in prospective donors. There was a high association between HIV and other blood-transmissible viruses.
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Affiliation(s)
- Silvina Alejandra Gendler
- Hemotherapy and Immunohematology Unit, Diagnosis and Treatment Department, Juan A. Fernández Hospital, Government of Buenos Aires City, Argentina.
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35
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Levi JE, Wendel S, Takaoka DT, Silva IC, Castro JPD, Torezan-Filho MA, Ghaname J, Gioachini R, Brandão J, Landi EP, Teixeira AC, Durigon EL. Replacement of HIV p24 Ag test by a multiplex RT-PCR method for primary screening of blood donors. Rev Inst Med Trop Sao Paulo 2007; 49:171-6. [PMID: 17625695 DOI: 10.1590/s0036-46652007000300007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Accepted: 11/24/2006] [Indexed: 11/22/2022] Open
Abstract
Nucleic Acid Testing (NAT) as a tool for primary screening of blood donors became a reality in the end of the 1990 decade. We report here the development of an "in-house" RT-PCR method that allows the simultaneous (multiplex) detection of HCV and HIV-RNA in addition to an artificial RNA employed as an external control. This method detects all HIV group M subtypes, plus group N and O, with a detection threshold of 500 IU/mL. After validation, the method replaced p24 Ag testing, in use for blood donation screening since 1996 at our services. From July 2001 to February 2006, 102,469 donations were tested and 41 (0.04%) were found HIV-RNA reactive. One NAT-only reactive donation (antibody non-reactive) was observed, with subsequent seroconversion of the implied donor, giving a yield of 1:102,469. This rate is in contrast to the international experience that reports a detection of approximately 1:600,000 - 1:3,100,000 of isolated HIV-RNA donations.
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Fiscus SA, Wiener J, Abrams EJ, Bulterys M, Cachafeiro A, Respess RA. Ultrasensitive p24 antigen assay for diagnosis of perinatal human immunodeficiency virus type 1 infection. J Clin Microbiol 2007; 45:2274-7. [PMID: 17475763 PMCID: PMC1933021 DOI: 10.1128/jcm.00813-07] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated an ultrasensitive p24 antigen enzyme immunosorbent assay on 802 plasma specimens from 582 infants and children of 0 to 180 days of age. Overall sensitivity and specificity were 91.7% and 98.5%, respectively. After exclusion of infants of less than 7 days of age, the sensitivity and specificity were 93.7% and 98.3%, respectively.
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Affiliation(s)
- Susan A Fiscus
- University of North Carolina at Chapel Hill, Department of Microbiology and Immunology, Chapel Hill, North Carolina, USA.
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Knuchel MC, Jullu B, Shah C, Tomasik Z, Stoeckle MP, Speck RF, Nadal D, Mshinda H, Böni J, Tanner M, Schüpbach J. Adaptation of the ultrasensitive HIV-1 p24 antigen assay to dried blood spot testing. J Acquir Immune Defic Syndr 2007; 44:247-53. [PMID: 17146373 DOI: 10.1097/qai.0b013e31802c3e67] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Implementation of molecular tests for the assessment of pediatric HIV-1 infection in resource-limited countries is difficult because of technical complexity and costs. Alternatives like the ultrasensitive HIV-1 p24 antigen enzyme-linked immunosorbent assay have therefore been proposed. We have now adapted this test to dried blood spot (DBS) plasma p24 antigen (p24). High background activity was recognized as originating from endogenous peroxidase and eliminated by H2O2 quenching. The assay was evaluated with 72 pediatric specimens from Tanzania and with 210 pediatric or adult specimens from Switzerland. A real-time polymerase chain reaction assay for DBS DNA and/or plasma RNA identified HIV-1 infection in 38 Tanzanian children. HIV-1 subtypes included 18 C, 9 A1, 8 D, 1 AC, 1 J-like, and 1 unidentified. The detection rates for the different assays were as follows: DBS-p24, 32 (84%) of 38 samples; DBS DNA, 30 (79%) of 38 samples; plasma-p24, 23 (85%) of 27 samples; and plasma RNA, 30 (100%) of 30 samples. False-negative DBS-p24 was associated with subtype D (P < 0.01). DBS-p24 detection for non-D subtypes was 93% (95% confidence interval: 81% to 99%), and for subtype C, it was 94% (95% confidence interval: 76% to 99%). Specificity among 193 HIV-negative DBS samples was 100%. Correlation of DBS-p24 and plasma-p24 concentrations was excellent (R = 0.83, P < 0.0001). DBS-p24 is thus a promising alternative to molecular tests for HIV-1 in subtype C regions. It should now be evaluated in large studies of children for accurate assessment of diagnostic sensitivity.
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Affiliation(s)
- Marlyse C Knuchel
- Swiss National Centre for Retroviruses, University of Zürich, Gloriastrasse 30/32, CH-8006 Zürich, Switzerland
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Jnaoui K, Lamarti N, Pâques AT, Goubau P. Prozone effect with the VIDAS HIV DUO Ultra assay. J Clin Virol 2007; 38:273-4. [PMID: 17223608 DOI: 10.1016/j.jcv.2006.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 12/07/2006] [Indexed: 11/16/2022]
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39
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Rouet F, Rouzioux C. The measurement of HIV-1 viral load in resource-limited settings: how and where? Clin Lab 2007; 53:135-48. [PMID: 17447649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
There is an urgent need for low-cost, simple, and accurate human immunodeficiency virus type 1 (HIV-1) viral load monitoring technologies in resource-limited settings, particularly at the time of the scaling-up of first and second-line highly active antiretroviral therapies. This review describes the main characteristics and advantages/ disadvantages of three alternative HIV-1 viral load methods currently evaluated and used in developing countries, i.e., the Ultra p24 antigen assay, the ExaVir Load reverse transcriptase activity test, and 'home-made' real-time PCR HIV-1 RNA techniques. This review discusses clinical results obtained with these three technologies in terms of correlation with commercial HIV-1 RNA assays, the impact of HIV-1 genetic diversity on quantification, as well as their usefulness for both the early diagnosis of pediatric HIV-1 infection and monitoring of highly active antiretroviral therapy efficiency. In addition, different strategies for HIV-1 viral load monitoring are discussed according to laboratory facilities in resource-constrained settings.
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Affiliation(s)
- Francois Rouet
- Laboratoire de Virologie, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa.
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40
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Fiscus SA, Pilcher CD, Miller WC, Powers KA, Hoffman IF, Price M, Chilongozi DA, Mapanje C, Krysiak R, Gama S, Martinson FEA, Cohen MS. Rapid, real-time detection of acute HIV infection in patients in Africa. J Infect Dis 2006; 195:416-24. [PMID: 17205481 DOI: 10.1086/510755] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 09/22/2006] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND We conducted a prospective study to evaluate methods of detecting clients with sexually transmitted diseases (STDs) who were acutely coinfected with human immunodeficiency virus (HIV) in Lilongwe, Malawi. METHODS After informed consent was obtained, all clients with acute STDs were offered voluntary HIV counseling and testing by 2 rapid antibody tests. Samples from rapid test-negative or -discordant subjects were pooled (50 : 5 : 1) and tested for HIV RNA. Western blots were performed on all rapid test-discordant specimens with detectable HIV RNA. A subset of specimens received p24 antigen testing with standard and/or ultrasensitive methods. Patients with possible acute HIV infection were followed to confirm seroconversion. RESULTS A total of 1450 clients (34% female and 66% male) agreed to testing, of whom 588 (40.55%) had established HIV infection and 21 (1.45%) had acute infection. Discordant rapid antibody tests identified 7 of 21 (33.3% sensitivity), standard p24 antigen identified 12 of 16 (75% sensitivity), and ultrasensitive p24 antigen identified 15 of 17 (88% sensitivity) acute cases. By definition, the sensitivity of the RNA assay was 100%. CONCLUSIONS Real-time pooled RNA testing for the detection of acute HIV infection is feasible in resource-limited settings. However, parallel rapid testing and p24 antigen testing are technologically simpler and together may detect approximately 90% of acute cases.
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Affiliation(s)
- Susan A Fiscus
- Department of Microbiology and Immunology, University of North Carolina (UNC) at Chapel Hill, Chapel Hill, NC 27599-7290, USA.
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41
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Burbelo PD, Ching KH, Mattson TL, Light JS, Bishop LR, Kovacs JA. Rapid antibody quantification and generation of whole proteome antibody response profiles using LIPS (luciferase immunoprecipitation systems). Biochem Biophys Res Commun 2006; 352:889-95. [PMID: 17157815 DOI: 10.1016/j.bbrc.2006.11.140] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Accepted: 11/19/2006] [Indexed: 12/12/2022]
Abstract
The application of LIPS to the rapid quantification of antibody responses to infectious agents is described. Chimeric genes encoding pathogen antigens fused to Renilla luciferase are expressed in mammalian cells; crude extracts are prepared and, without purification, employed in immunoprecipitation assays to quantify pathogen-specific antibodies. In cross-sectional and longitudinal studies, antibody levels to the MSG-14 antigen of Pneumocystis jirovecii measured by this assay correlated well with levels previously obtained with an optimized ELISA. We also correctly predicted Hepatitis B (HBV), Hepatitis C (HCV), and HIV infection status in all but 2 of 99 assays analyzing 33 patient sera. We then used 15 HIV-encoded proteins comprising the whole HIV proteome to generate antibody response profiles for these 33 sera. Each HIV antigen was recognized by antibodies in serum from at least one HIV-infected individual. Data generated with these simple, quantitative antibody-detection assays have both clinical and research applications.
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Affiliation(s)
- Peter D Burbelo
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA.
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42
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Adalid-Peralta L, Grangeot-Keros L, Rudent A, Ngo-Giang-Huong N, Krzysiek R, Goujard C, Deveau C, Le Gall M, Meyer L, Emilie D, Rouzioux C. Impact of highly active antiretroviral therapy on the maturation of anti-HIV-1 antibodies during primary HIV-1 infection. HIV Med 2006; 7:514-9. [PMID: 17105510 DOI: 10.1111/j.1468-1293.2006.00406.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To study the impact of highly active antiretroviral therapy (HAART) on isotype switching and avidity maturation of HIV-1-specific immunoglobulin G (IgG) in patients with primary HIV-1 infection (PHI). METHODS We studied the emergence and the evolution of anti-HIV IgG antibodies by quantitative immunoblotting to analyse IgG subclasses and IgG avidity. Serum samples were obtained from 16 PHI patients from the French PRIMO Cohort Study at various points in the first year of infection: eight patients received no treatment (group I), and eight patients received efficient HAART (group II) during the study period. RESULTS Early initiation of HAART in PHI patients partially prevented an increase in anti-HIV-1 IgG levels. Within IgG subclasses, the amount of anti-HIV-1 IgG1 gradually increased with time in both groups, although levels remained lower in treated patients. The anti-p24 IgG2 level was always lower in group II. We observed a decrease in anti-p24 IgG3 over time in both groups. Treatment did not affect the maturation of HIV-1 IgG avidity, which increased in both groups until month 3 and then remained high until the end of the 12-month follow-up period. CONCLUSIONS HAART in PHI partially prevents the emergence of HIV-1 IgG antibodies, but does not affect the quality of these antibodies, as reflected in their isotype and avidity.
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Affiliation(s)
- L Adalid-Peralta
- INSERM U764, Institut Fédératif de Recherches 13, Clamart, France
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Tehe A, Maurice C, Hanson DL, Borget MY, Abiola N, Maran M, Yavo D, Tomasik Z, Böni J, Schüpbach J, Nkengasong JN. Quantification of HIV-1 p24 by a highly improved ELISA: An alternative to HIV-1 RNA based treatment monitoring in patients from Abidjan, Côte d’Ivoire. J Clin Virol 2006; 37:199-205. [PMID: 16973409 DOI: 10.1016/j.jcv.2006.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2006] [Revised: 07/18/2006] [Accepted: 08/02/2006] [Indexed: 11/23/2022]
Abstract
BACKGROUND Quantification of HIV-1 RNA remains difficult to implement in Africa. Simple and inexpensive tests for antiretroviral treatment (ART) monitoring are needed. OBJECTIVE To evaluate an HIV-1 p24 ELISA, which combines efficient virus disruption, heat-denaturation and signal amplification, in a West African setting. STUDY DESIGN Eighty-six HIV-1 infected patients from Abidjan, Côte d'Ivoire, were tested for p24, HIV-1 RNA, and CD4+ count at baseline, and twice within 8 months after ART initiation. RESULTS All patients responded to ART with a minimal HIV-1 RNA drop of 0.5 log(10) at first follow-up. Forty-one (47.7%) then rebounded >0.5 log(10) or persisted above 1000 copies/mL by week 24. The predicted baseline concentration of p24 corresponding to 100,000 copies/mL of HIV-1 RNA, above which ART is recommended, was 4546 fg/mL (95% confidence interval 3148-6566). A prediction model of virologic failure, occurring after an initial response to ART, correctly classified 84% of patients using baseline p24, p24 change on therapy, and achievement of undetectable p24 as explanatory variables. The model and further bootstrap evaluation suggested a good ability to discriminate between sustained or failing virologic response to ART. CONCLUSION HIV-1 p24 and RNA based-ART monitoring in a low-resource country dominated by HIV-1 CRF02 AG appeared comparable.
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Affiliation(s)
- Andre Tehe
- Projet RETRO-CI, Abidjan, Côte d'Ivoire.
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Abstract
The authors discuss studies on the low-cost viral load assays that are currently available and their potential for use in resource-limited settings.
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Affiliation(s)
- Susan A Fiscus
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
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45
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Nübling CM, Chudy M, Volkers P, Löwer J. Neopterin levels during the early phase of human immunodeficiency virus, hepatitis C virus, or hepatitis B virus infection. Transfusion 2006; 46:1886-91. [PMID: 17076842 DOI: 10.1111/j.1537-2995.2006.00994.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A study was conducted to assess the diagnostic sensitivity of neopterin screening of blood donors with regard to the detection of window-phase specimens of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infection. STUDY DESIGN AND METHODS In total, 1002 diagnostic window-phase specimens from 98 seroconversion panels (29 HIV-1, 52 HCV, and 17 HBV) were analyzed with viral antigen detection, viral nucleic acid amplification testing (NAT), and neopterin quantitation assays. The study was completed by the analysis of 92 anti-hepatitis B core antigen (HBc)-reactive and 103 alanine aminotransferase (ALT)-elevated blood donor specimens. RESULTS A significant association between elevated neopterin concentrations and the very early phase of HIV-1 infection was found. No significant correlation could be observed between neopterin levels and the early phase of HCV or HBV infection. Neopterin concentration was not increased in specimens from blood donors with anti-HBc reactivity or ALT elevation. CONCLUSIONS Neopterin screening of blood donors may identify window-phase cases of HIV, but not of HCV or HBV infection. The diagnostic sensitivity of neopterin screening during the HIV window phase is similar to that of the p24 antigen test. With the introduction of viral NATs in blood screening, there is no additional benefit of neopterin screening with regard to the three blood-borne viruses HIV, HCV, and HBV. Acute phases of other infectious agents, however, have been reported to be detected by neopterin enzyme-linked immunosorbent assays.
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Yeom JS, Jun G, Chang Y, Sohn MJ, Yoo S, Kim E, Ryu SH, Kang HJ, Kim YA, Ahn SY, Cha JE, Youn ST, Park JW. Evaluation of a new fourth generation enzyme-linked immunosorbent assay, the LG HIV Ag-Ab Plus, with a combined HIV p24 antigen and anti-HIV-1/2/O screening test. J Virol Methods 2006; 137:292-7. [PMID: 16908076 DOI: 10.1016/j.jviromet.2006.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2005] [Revised: 07/01/2006] [Accepted: 07/04/2006] [Indexed: 10/24/2022]
Abstract
The LG HIV Ag-Ab Plus, a new fourth generation diagnostic assay for HIV infection, was evaluated in comparison to the Enzygnost HIV Integral, an established fourth generation HIV assay. The LG assay showed 100% sensitivity with 109 samples with anti-HIV-1, anti-HIV-2 or anti-HIV-1 group O reactivity. It also detected correctly all 51 positives on three BBI performance panels, slightly outperforming the Enzygnost HIV Integral, which detected 50. The specificity of the LG HIV Ag-Ab Plus was 99.9% with 999 sera from healthy blood donors, which was slightly inferior to the performance of the Enzygnost HIV Integral, which had 100% specificity. The LG assay showed 100% specificity with 81 specimens with underlying diseases including hepatitis B, demonstrating a low risk of cross-reactivity with other infections. The reduction of the diagnostic window by the LG HIV Ag-Ab Plus, compared to a third generation HIV assay, was 6.3 days. The LG assay also showed sufficiently high intra-person and inter-person reproducibility. The overall performance of this new fourth generation HIV assay was adequate for screening and diagnosis of HIV infection.
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Affiliation(s)
- Joon-Sup Yeom
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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47
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Ben Mamou M, Slim A, Garbouj M, Ben Redjeb S. [Virological diagnosis and follow-up of HIV infection. State of the art and situation in Tunisia]. Tunis Med 2006; 84:395-402. [PMID: 17039728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Human immunodeficiency virus (HIV) is a retrovirus infecting approximatively 40 million people worldwide. HIV is characterized by a great variability with epidemiological, diagnostic and therapeutic implications. The course of infection goes through three stages (acute infection, clinical latency and AIDS) with the evolution of virological markers (anti-HIV antibodies, p24 antigenemia, plasma RNA and proviral DNA). Direct virological diagnosis is mainly based on molecular tools allowing viral genome detection and amplification with specific primers and nucleic probes besides p24 antigenemia detection, and more rarely viral culture. Antigenic properties of viral proteins elicit in infected patients antibody synthesis, which is detected using serology (ELISA and Western blot tests). The follow-up of infected patients is carried out with plasma HIV-1 RNA quantitation and phenotypic or genotypic characterization of variant isolates. Virological tests are prescribed according to clinical presentation (screening, acute infection, newborn from HIV-infected mother). Most of these virological tools are available in Tunisia, allowing both diagnosis of HIV infection and monitoring of infected individuals. Regarding diagnostic tests indication and interpretation, multidisciplinary concertation is hopeful in order to optimize patient management.
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Affiliation(s)
- Myriam Ben Mamou
- Laboratoire de Microbiologie, Centre National de Référence du VIH, Hôpital Charles Nicolle, Tunis
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Brinkhof MWG, Böni J, Steiner F, Tomasik Z, Nadal D, Schüpbach J. Evaluation of p24-based antiretroviral treatment monitoring in pediatric HIV-1 infection: prediction of the CD4+ T-cell changes between consecutive visits. J Acquir Immune Defic Syndr 2006; 41:557-62. [PMID: 16652029 DOI: 10.1097/01.qai.0000209824.77784.2c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Worldwide, 700,000 infants are infected annually by HIV-1, most of them in resource-limited settings. Care for these children requires simple, inexpensive tests. We have evaluated HIV-1 p24 antigen for antiretroviral treatment (ART) monitoring in children. p24 by boosted enzyme-linked immunosorbent assay of heated plasma and HIV-1 RNA were measured prospectively in 24 HIV-1-infected children receiving ART. p24 and HIV-1 RNA concentrations and their changes between consecutive visits were related to the respective CD4+ changes. Age at study entry was 7.6 years; follow-up was 47.2 months, yielding 18 visits at an interval of 2.8 months (medians). There were 399 complete visit data sets and 375 interval data sets. Controlling for variation between individuals, there was a positive relationship between concentrations of HIV-1 RNA and p24 (P < 0.0001). While controlling for initial CD4+ count, age, sex, days since start of ART, and days between visits, the relative change in CD4+ count between 2 successive visits was negatively related to the corresponding relative change in HIV-1 RNA (P = 0.009), but not to the initial HIV-1 RNA concentration (P = 0.94). Similarly, we found a negative relationship with the relative change in p24 over the interval (P < 0.0001), whereas the initial p24 concentration showed a trend (P = 0.08). Statistical support for the p24 model and the HIV-1 RNA model was similar. p24 may be an accurate low-cost alternative to monitor ART in pediatric HIV-1 infection.
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Affiliation(s)
- Martin W G Brinkhof
- Institute for Social and Preventive Medicine, University of Berne, Berne, Switzerland
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Aboud S, Urassa W, Lyamuya E, Mhalu F, Biberfeld G. Evaluation of HIV antibody and antigen/antibody combination ELISAs for use in an alternative confirmatory HIV testing strategy in Dar es Salaam, Tanzania. J Virol Methods 2006; 135:192-6. [PMID: 16647764 DOI: 10.1016/j.jviromet.2006.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2006] [Revised: 03/10/2006] [Accepted: 03/16/2006] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the performance of two antibody enzyme-linked immunosorbent assays (ELISAs) [Vironostika Uni-Form II plus O and Enzygnost anti-HIV-1/2 Plus], and two antigen/antibody combination ELISAs [Murex and Vironostika HIV Uni-Form II] for use in an alternative confirmatory HIV diagnostic testing strategy in Dar es Salaam, Tanzania. Altogether, 1380 serum samples were included. All ELISA reactive samples were tested using the Inno-Lia antibody assay and discrepant samples were tested on the Innotest p24 antigen assay. Three hundred and one (21.8%) samples were confirmed HIV-1 antibody positive by Inno-Lia including 27/508 (5.3%) from blood donors, 65/511 (12.7%) from pregnant women and 209/361 (57.9%) from hospital patients. The sensitivity at initial testing was 100% (95% CI; 98.8-100%) for all assays except Vironostika Uni-Form II plus O (99.7%; 95% CI; 98.2-99.9%) which showed one false negative sample at initial testing but 100% sensitivity after repeat testing. The final specificity at repeat testing was 100% (95% CI; 99.7-100%) for Enzygnost anti-HIV-1/2 Plus, 99.4% (95% CI; 98.8-99.8%) for each of the antigen/antibody combination ELISAs and 97.9% (95% CI; 96.8-98.6%) for Vironostika plus O ELISA. An alternative confirmatory HIV testing strategy based on initial testing on any of the two antigen/antibody assays followed by testing of reactive samples on the Enzygnost anti-HIV-1/2 Plus assay gave 100% specificity (95% CI; 99.7-100%).
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Affiliation(s)
- Said Aboud
- Department of Microbiology and Immunology, Muhimbili University College of Health Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Knuchel MC, Tomasik Z, Speck RF, Lüthy R, Schüpbach J. Ultrasensitive quantitative HIV-1 p24 antigen assay adapted to dried plasma spots to improve treatment monitoring in low-resource settings. J Clin Virol 2006; 36:64-7. [PMID: 16431154 DOI: 10.1016/j.jcv.2005.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Revised: 11/11/2005] [Accepted: 12/10/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Our group has previously developed a quantitative and ultrasensitive HIV-1 p24 antigen assay that is inexpensive, easy-to-perform, and can be carried out in low-resource settings. Since antiretroviral therapies are becoming more accessible in resource-constrained countries, methods to assess HIV-1 viraemia are urgently needed to achieve a high standard of care in HIV-1 management. OBJECTIVES To adapt our quantitative assay to dried plasma spots (DPS), in order to further simplify this test and make it more accessible to resource-constrained countries. STUDY DESIGN DPS from 47 HIV-seropositive, treated or untreated adult individuals and 30 healthy individuals were examined. RESULTS A specificity of 100% was observed when p24 antigen was measured using DPS, and no differences of p24 concentration could be seen between DPS and venous plasma. The correlation between DPS and venous plasma p24 was excellent (R=0.93, CI(95%)=0.88-0.96, p<0.0001). Similarly, p24 antigen concentrations using DPS were well correlated with RNA viral load (R=0.53, CI(95%)=0.27-0.72, p=0.0002). CONCLUSIONS This quantitative p24 antigen test has similar sensitivity and specificity using DPS and venous plasma, and has the potential to improve health care delivery to HIV-affected individuals in resource-constrained countries.
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Affiliation(s)
- Marlyse C Knuchel
- Swiss National Center for Retroviruses, University of Zürich, Gloriastrasse 30/32, CH-8006 Zürich, Switzerland
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