TITLE

Rapid, Real-Time Detection of Acute HIV Infection in Patients in Africa

AUTHOR(S)

Fiscus, Susan A.; Pilcher, Christopher D.; Miller, William C.; Powers, Kimberly A.; Hoffman, Irving F.; Price, Matthew; Chilongozi, David A.; Mapanje, Clement; Krysiak, Robert; Gama, Syze; Martinson, Francis E. A.; Cohen, Myron S.

PUB. DATE

February 2007

SOURCE

Journal of Infectious Diseases;2/1/2007, Vol. 195 Issue 3, p416

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

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 ~90% of acute cases.

ACCESSION #

23819751

Tags: HIV infections;  HIV (Viruses);  RNA;  SEX education;  SEXUAL health

 

Related Articles

• Let's Talk About Sex. Sepkowitz, Kent // Newsweek;3/12/2012, Vol. 159 Issue 11, p14 

  The article discusses sex education and the transmission of HIV in the U.S., arguing that transmission rates have not dropped in the U.S. due to a lack of conversation on the topic and examining the attitudes of both Republicans and Democrats towards discussions of sex.

• Comparison between Rules-Based Human Immunodeficiency Virus Type 1 Genotype Interpretations and Real or Virtual Phenotype: Concordance Analysis and Correlation with Clinical Outcome in Heavily Treated Patients. Torti, Carlo; Quiros-Roldan, Eugenia; Keulen, Wilco; Scudeller, Luigia; Caputo, Sergio Lo; Boucher, Charles; Castelli, Francesco; Mazzotta, Francesco; Pierotti, Piera; Been-Tiktak, Anne Mieke; Buccoliero, Giovanni; De Gennaro, Michele; Carosi, Giampiero; Tinelli, Carmine // Journal of Infectious Diseases;7/15/2003, Vol. 188 Issue 2, p194 

  We compared 2 rules-based genotype interpretation systems and real or virtual phenotype through a retrospective analysis of a prospective trial. Genotypes were determined with VircoGEN II (VIRCO) and were interpreted with either RetroGram 1.4 or TRUGENE HIV-1 (guidelines 3.0) or original virtual...

• siRNA-directed inhibition of HIV-1 infection. Novina, Carl D.; Murray, Michael F.; Dykxhoorn, Derek M.; Beresford, Paul J.; Riess, Jonathan; Lee, Sang-Kyung; Collman, Ronald G.; Lieberman, Judy; Shankar, Premlata; Sharp, Phillip A. // Nature Medicine;Jul2002, Vol. 8 Issue 7, p681 

  RNA interference silences gene expression through short interfering 21?23-mer double-strand RNA segments that guide mRNA degradation in a sequence-specific fashion. Here we report that siRNAs inhibit virus production by targeting the mRNAs for either the HIV-1 cellular receptor CD4, the viral...

• HIV shedding in the oral cavity: an assessment of HIV type, immunovirologic, demographic and oral factors. Pavlinac, Patricia B.; Hawes, Stephen E.; Gottlieb, Geoffrey S.; Gaye, Awa; N'Diaye, Charlotte F.; Critchlow, Cathy W.; Sow, Papa Salif; Feng, Qinghua; Kiviat, Nancy B. // Sexually Transmitted Infections;Feb2012, Vol. 88 Issue 1, p45 

  Objective To quantify the prevalence and burden of HIV type 2 (HIV-2) and HIV-1 RNA in the oral cavity of antiretroviral therapy-naive HIV-infected Senegalese individuals and to identify correlates of oral HIV viral loads. Design A cross-sectional study of 163 HIV-1 and 27 HIV-2-infected...

• Relationship between pre-existing viral reservoirs and the re-emergence of plasma viremia after discontinuation of highly active anti-retroviral therapy. Chun, Tae-Wook; Davey, Richard T.; Ostrowski, Mario; Shawn Justement, J.; Engel, Delphine; Mullins, James I.; Fauci, Anthony S. // Nature Medicine;Jul2000, Vol. 6 Issue 7, p757 

  We examined the pathogenic significance of the latent viral reservoir in the resting CD4+ T cell compartment of HIV-1-infected individuals as well as its involvement in the rebound of plasma viremia after discontinuation of highly active anti-retroviral therapy (HAART). Using heteroduplex...

• ART Suppresses Plasma HIV-1 RNA to a Stable Set Point Predicted by Pretherapy Viremia. Maldarelli, Frank; Palmer, Sarah; King, Martin S.; Wiegand, Ann; Polis, Michael A.; Mican, JoAnn; Kovacs, Joseph A.; Davey, Richard T.; Rock-Kress, Diane; Dewar, Robin; Shuying Liu; Metcalf, Julia A.; Rehm, Catherine; Brun, Scott C.; Hanna, George J.; Kempf, Dale J.; Coffin, John M.; Mellors, John W. // PLoS Pathogens;Apr2007, Vol. 3 Issue 4, pe46 

  Current antiretroviral therapy is effective in suppressing but not eliminating HIV-1 infection. Understanding the source of viral persistence is essential for developing strategies to eradicate HIV-1 infection. We therefore investigated the level of plasma HIV-1 RNA in patients with viremia...

• Protease inhibitors linked to clearance rate.  // AIDS Patient Care & STDs;Nov98, Vol. 12 Issue 11, p871 

  Features a Dutch study showing that rates of initial plasma HIV-1 RNA clearance are higher in patients receiving higher levels of protease inhibitor exposure. Elimination rate constant variation in patients 34 studied; Positive link between the rate constants and the concentration rate of...

• The HIV RNA setpoint theory revisited. Geskus, Ronald B.; Prins, Maria; Hubert, Jean-Baptiste; Miedema, Frank; Berkhout, Ben; Rouzioux, Christine; Delfraissy, Jean-Francois; Meyer, Laurence // Retrovirology;2007, Vol. 4, p65 

  Background: The evolution of plasma viral load after HIV infection has been described as reaching a setpoint, only to start rising again shortly before AIDS diagnosis. In contrast, CD4 T-cell count is considered to show a stable decrease. However, characteristics of marker evolution over time...

• APOBEC3G mRNA expression in exposed seronegative and early stage HIV infected individuals decreases with removal of exposure and with disease progression. V�zquez-P�rez, Joel A.; Ormsby, Christopher E.; Hern�ndez-Juan, Ram�n; Torres, Klintsy J.; Reyes-Ter�n, Gustavo // Retrovirology;2009, Vol. 6, p1 

  Background: APOBEC3G is an antiretroviral factor that acts by inducing G to A mutations. In this study, we examined the expression of APOBEC3G in uninfected HIV-1 exposed individuals at the time of their partner's diagnosis and one year later. We then compared this expression with that of...

Read the Article